Seroprevalence of HBV, HCV and HDV hepatitis markers in 500 patients infected with the human immunodeficiency virus

The serological status for both hepatitis B, C and D viruses was analyzed for 500 HIV seropositive patients and for 1037 of a control group. The prevalence was 31.4% for anti HCV, 13.8% for HBs Ag and 69.0% for one or more HBV markers in HIV positive patients and respectively 2.5%, 2.7% and 13.1% in control group. The markers for hepatitis D were founded among 21% of the HBs Ag carriers (patients and control group), correlated with drug i.v. use. The prevalence of anti-HCV was 71.6% in subjects who had blood-borne HIV infection and 1.5% in those with sexually acquired infection. The prevalence in control group was 10.2% and 1.7% respectively according to the same risk factors. The prevalence of HBs Ag was higher among HIV positive patients with sexual risk (17.5%) than with blood exposition (9.9%) and a variation in the same direction is observed in control group (3% v.s. 1%). The relation between markers for hepatitis B and hepatitis C was negative.     

The prevalence of Dirofilaria immitis in Gran Canaria, Canary Islands, Spain (1994-1996)

Blood samples from 2034 dogs were tested to detect Dirofilaria immitis antigen during three consecutive years (from 1994 to 1996) in Gran Canaria Island, Canary Islands, Spain. The prevalence of heartworm infection was 67.02% in 1994, 58.92% in 1995 and 52.18% in 1996, with a mean prevalence of 58.89%. Heartworm infection was more common in males (56.19%) than in females (43.81 %), in dogs aged between 3 and 6 years old. The distribution of the disease in the different climatic zones was studied. Chronological changes in the dog's prevalence for heartworm infection in the three consecutive years and the role of the epidemiological factors in the changes of the positive rates were evaluated.     

A qualitative investigation into an HIV outbreak among injection drug users in Vancouver, British Columbia

The effect of Cd, Cu, Zn, Hg, and Pb solutions at various concentrations, on the restoration potential of the leaves of Portulaca oleracea was tested. All the trace metals completely affected the shoot regeneration. The degree of their effect on root regeneration, however, varied. Early initiation of parental leaf decay was also observed. The order of their relative effect on the regeneration process was: Cd > Cu > Zn > Hg > Pb.     

Evaluation of a video-supplement to informed consent: injection drug users and preventive HIV vaccine efficacy trials

In rats injected with bacterial lipopolysaccharide (LPS; 5 gamma mg/g body weight [BWT]), the toxin provokes death within 24 h in 23% of the animals and, in surviving rats, causes a decrease in BWT, hyperlactacidemia, hyperlipacidemia, and hyperketonemia, as well as depletion of both liver and muscle glycogen content. In the liver, LPS severely lowers the ATP and total adenine nucleotide content, ATP/ADP ratio, and adenylate charge. In hepatocytes from LPS-injected rats, the oxidation of D-glucose is first increased 2 h after administration of the toxin, despite close-to-normal phosphorylation of the hexose. In hepatocytes prepared from rats killed 24 h after injection of LPS, the phosphorylation of D-glucose, its incorporation into glycogen, and its oxidation are all severely impaired. This sequence of changes, which coincides with a decreased ratio between pyruvate and lactate production from exogenous D-glucose, is comparable to that found with agents that uncouple oxidative phosphorylation. The injection of LPS also alters the metabolic response of hepatocytes to the dimethyl ester of succinic acid (SAD), in terms, for instance, of the sparing action of the ester upon both the production of 14CO2 by hepatocytes prelabeled with L-[U-14C] glutamine and the output of NH4+, and its inhibitory action on glycogenolysis and futile cycling in the reactions catalyzed by glucokinase and glucose-6-phosphatase. Nevertheless, the infusion of SAD protects the rats against the deleterious effect of LPS upon such variables as the plasma concentration of free fatty acids and beta-hydroxybutyrate, the liver ATP content, and the oxidation of D-glucose, as well as the pyruvate/lactate ratio, in hepatocytes prepared from the LPS-injected rats. The infusion of SAD also virtually suppresses lethality in the LPS-injected animals. It is proposed, therefore, that the infusion of succinic acid esters may represent a novel therapeutic approach in endotoxemia and multiple-organ failure.     

Depression and HIV disease in injection drug users: A Spanish language feasibility study.

Developed and tested a mood management intervention to assess its feasibility and effect on mood, drug use, and high-risk behaviors related to HIV in Spanish-speaking injection drug users. Ss were 35 Latino patients at a San Francisco methadone maintenance clinic, 11 of whom agreed to participate. From pretest and posttest interview data, difference scores were computed and analyzed between the participating and nonparticipating comparison groups. The study demonstrated the feasibility of short-term cognitive-behavioral interventions with this Spanish-speaking sample. Results suggest that the intervention moderated the depressive symptoms of the participants, including the HIV positive individuals. No significant changes were found in drug use and HIV-related high-risk behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The risk of transmitting HCV, HBV or HIV by blood transfusion in Victoria

OBJECTIVE: To report the incidence rate of hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV in Victorian repeat blood donors and to derive the residual risk of transmission of the viruses by screened blood transfusion. DESIGN: The interval from the previous whole blood donation was extracted retrospectively from Victorian Red Cross Blood Bank records for each of the 358332 repeat donations given between March 1994 and December 1995. Records of repeat donors found positive for the viruses in this period were traced to the previous seronegative donation and accepted if screened by the same test. For each virus, the number of previous donations screened by the same test was calculated and the sum of all donation intervals used to derive the incidence of infection in the repeat donor population. Published intervals after infection (when a donation can be infective although seronegative) were used to calculate the risk of release of a seronegative unit which would be infective. PARTICIPANTS AND SETTING: Homologous blood donors at the Red Cross Blood Bank of Victoria. MAIN OUTCOME MEASURES: Incidence rate of HBV, HCV and HIV in regular blood donors and risk of infective donations being seronegative. RESULTS: The incidence of infection in repeat donors was: HBV: 1.67 per 100000 person-years; HCV: 1.89 per 100000 person-years; and HIV: 1.31 per 100000 person-years. The risk of a seronegative repeat donation being infective was: HBV: 2.71 per million donations (adjusted to 6.45 to account for viraemias which remain seronegative); HCV: 4.27 per million donations; and HIV: 0.79 per million donations. CONCLUSION: The risk of transmitting HCV, HBV or HIV by repeat blood donors is low and compares favourably with overseas data. Repeat donors have an incidence rate of HIV and HBV comparable to that of the general population, but the incidence rate of HCV is lower for repeat donors than in the general population.     

HIV knowledge, beliefs and sexual behavior of male heterosexual drug users and non-drug users attending an HIV testing clinic in Israel

The aim of the study was to compare HIV-related knowledge, beliefs in self-control and sexual behavior of non-drug using and drug using heterosexual men. All individuals attending an HIV testing site during a two-month period were asked to complete a questionnaire anonymously. Data for 49 drug users (DU), most of them non-injectors, were compared to that of 94 non-drug using (non-DU) men with similar education levels (high school or less). Sexual behavior items refer to previous six months. FINDINGS: HIV-related knowledge was reported correctly by the majority of men in both groups, but the DU showed significantly more misconceptions (p < 0.01). Consistent but statistically insignificant lower levels of self-control were reported by the DU. Type of sexual relations and the number of regular sexual partners were not different between the groups: 55% of the DU and 67% of the non-DU were not monogamous. DU had either none or many casual partners (three or more), significantly different from the non-DU. The proportion of DU who never used condoms (65%) was higher as compared to non-DU men (43%, p < 0.05). However, when controlling for type of partnership, this difference was sustained only among monogamous men (82% of DU vs. 42% of non-DU never used condoms, p < 0.05). Condom use was significantly associated with age, HIV knowledge and sexual partnership in the DU. The greater deficiencies in HIV-related knowledge, and the prevalence of risk behaviors among DU require intensive individual and group counselling, specifically adapted for the needs and the culture of drug users in Israel and incorporated with social-influence-orientated change processes.     

Prevalence of blood-borne viruses among intravenous drug users and alcoholics in Hiroshima, Japan

We investigated the prevalence of human immunodeficiency viruses-1 and 2 (HIV-1 and HIV-2), human T-lymphotropic virus type I and II, hepatitis B virus (HBV), hepatitis C virus (HCV) and hepatitis D virus among intravenous drug users (IVDU) in Hiroshima, Japan, where little is known about their present levels. From June to December 1993, serum samples were collected from 47 IVDU and 98 alcoholics in Hiroshima, Japan, and examined for markers of virus infection. The prevalence of antibody to HCV (anti-HCV) and/or HCV-RNA was significantly higher in IVDU than alcoholics (74.5% vs 20.4%, 44.7% vs 10.2% respectively, P < 0.001). In contrast, the prevalence of antibody to hepatitis B surface antigen and/or core antigen (anti-HBs and/or anti-HBc) showed no significant difference between the 2 groups (57.4% vs 66.3%). HIV-1 infection was found in one (2.1%) IVDU and genome analysis indicated that it was subtype B according to Myers' classification. Thus, an extremely low level of HIV infection and a high level of HCV infection was found in IVDU. Careful follow-up of this group is thought to be needed to minimize an outbreak of HIV-1 infection in Japan.     

HIV/HTLV-II coinfection and CD4+ cell count controlling for plasma HIV viral load in injection drug users in Baltimore

The private sector, and drug companies in particular, are beginning to play a much stronger and visible role in funding health care research in canada. The implications of this change were discussed at a recent conference.     

Attitudes and practices of pharmacy managers regarding needle sales to injection drug users

Neurologic disease, already common in the United States, will become even more common in the future. But presently, neurology education at the undergraduate level and in primary care residencies is declining and does not adequately train physicians to manage neurologic illness. The authors maintain that this serious problem can be partially addressed by improving the neurology education of all primary care physicians and by allowing students access to neurology specialists. The education of medical students in the basic and clinical neurosciences must be integrated into a seamless curriculum over the four years of medical education. This education experience must be taught through a team approach and must be led by both a clinician and a basic scientist. All medical students must acquire the knowledge, skills, and attitudes necessary to perform an initial evaluation of the patient with a neurologic complaint. Finally, students must understand the role and recognize the importance of the neurologist and know when consultation is needed. This continuum of neurology education must be financially supported by the institution, and course leaders who show excellence in education must be rewarded with compensation and promotion.     

Seroconversion to HBV associated with seroconversion to HIV in a cohort of intravenous drug misusers in Turin, Italy

Between March 1986 and March 1994, the seroconversion to HBV associated to the seroconversion to HIV was investigated in 120 HIV seroconverters drawn from 2368 i.v. drug misusers screened for HIV, HBV and STDs. Among the 185 individuals susceptible to HIV and HBV at intake (41/120 HIV seroconverters and 144/364 HIV-negative controls), HBV seroconversion was associated with the seroconversion to HIV (p = 0.006) and history of more than 3 sexual partners per year (p = 0.000). Only the history of more than 3 partners per year remained associated with the HBV seroconversion in the conditional regression. The associated seroconversion to HIV and HBV was linked to the short period of i.v. drug injections (p = 0.032), history of more than 3 partners per year (p = 0.000) and more than 3 i.v. drug injections per day (p = 0.016). Compared to the seroconverters to HBV alone, the seroconverters to HBV and HIV were likely to have higher frequency of i.v. drug injection per day on univariate (p = 0.031) and multivariate analysis (p = 0.024). The seroconverters to both the viruses differed from the seroconverters to HIV alone in the year of drug debut (p = 0.045), short period of i.v. drug use (p = 0.048) and high frequency of injection per day (p = 0.008). The multivariate analysis confirmed only the association with high frequency of injection per day (p = 0.033). Higher risk of HIV seroconversion from the debut of i.v. drug use was observed in the subjects with concurrent HBV seroconversion (Log-Rank test: p = 0.0008).     

Incidence and risk factors for hepatitis C among injection drug users in Baltimore, Maryland

Between 1988 and 1996, the incidence of and risk factors for hepatitis C virus (HCV) infection were studied in a cohort of injection drug users in Baltimore, Maryland. By second-generation antibody testing of stored serum samples, 142 participants were found to be susceptible to HCV at the time they entered the study. After a median follow-up of 6.5 years, 43 participants (30.3%) developed antibodies to HCV (anti-HCV). The overall incidence was 6.4 cases per 100 person-years, but a substantial decline in the annual incidence rate was observed after the first 2 years (1988 to 1990, 13.4/100 person-years; 1991 to 1996, 2.3/100 person-years [P = 0.0001 for trend]). Participants who acknowledged active drug use, especially those who acknowledged frequent use and sharing of drug paraphernalia, were at increased risk of HCV infection. However, high-risk sexual practices were not associated with HCV seroconversion. Efforts to reduce HCV infection must be focused on curbing drug use and especially on the sharing of needles and drug paraphernalia.     

Relationship among gender, depression and needle sharing in a sample of injection drug users.

The authors explored the relationships among gender, needle sharing, and depression in a sample of 392 male and 121 female street drug users. Using the Risk Behavior Assessment (National Institute on Drug Abuse, 1991) and the Beck Depression Inventory--2 (A. T. Beck, R. A. Steer, & G. K. Brown, 1996), the authors found that women reported higher levels of depression than men and that sharers endorsed higher levels of depression than nonsharers. Further, the authors found that female sharers reported the highest levels of depression of all groups, that is, as compared with male sharers, female nonsharers, and male nonsharers, who did not differ from one another. This suggests the presence of a special dynamic between gender and depression that is related to higher rates of needle sharing among women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychometric evaluation of the quality of life interview, brief version, in injection drug users.

The authors investigated the psychometric characteristics of the Quality of Life Interview, Brief Version (QOLI-BV; A. F. Lehman, 1995) in 126 injection drug users recruited for a clinical trial. The QOLI-BV assesses global and domain-specific quality of life. Participants completed the instrument at baseline and 3 and 6 months later. Most scales showed acceptable internal consistency. Convergent and discriminant validity were demonstrated through correlations with the SF-36, the Beck Depression Inventory, and demographic variables. Scale means rose over time, suggesting that the QOLI-BV is sensitive to change. Unexpectedly, lower baseline QOLI-BV scores predicted opiate abstinence at follow-up. The QOLI-BV appears to be an acceptable quality-of-life measure for use in clinical trials of opioid dependence treatments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevalence of HIV infection and HIV risk behaviors associated with living place: on-the-street homeless drug users as a special target population for public health intervention

The study described here examined the prevalence of HIV infection as a function of place of residence and high-risk behaviors in six subpopulations of out-of-treatment drug injectors and crack cocaine users who participated in the National Institute on Drug Abuse (NIDA) Cooperative Agreement project. The subpopulations were blacks, Hispanics, and non-Hispanic whites sampled separately by gender. The research asked three questions: (a) Is the HIV infection rate higher among the on-the-street homeless than among those in other places of residence? (b) Do high-risk drug-related behaviors differ by housing status? and (c) What are the joint effects of high-risk drug-related behaviors and housing status on the probability of HIV infection? Overall, on-the-street homeless had a significantly higher HIV+ rate (19.0%) than the study population as a whole (11.2%). Rates differed by gender and race, with exceptionally high HIV+ rates for on-the-street homeless Hispanic males (29%) and females (32%) and for on-the-street homeless black females (38%). Having used drug works previously used by a HIV-infected person was a strong predictor of HIV+ status, as was frequency of drug injections and crack use. Having multiple sex partners was also a significant risk behavior. Findings argue against considering on-the-street homelessness as equivalent to shelter dwelling or aggregated homelessness for purposes of the AIDS epidemic. On-the-street homeless drug users were at strong risk for acquisition and transmission of HIV infection and therefore in need of targeted-racially relevant, ethnically relevant, and gender-relevant-public health interventions to help prevent the spread of AIDS.     

Cohort study of HIV infection among drug users in Ruili, Longchuan and Luxi of Yunnan Province, China

Among Hong Kong Chinese blood donors, 99.71 percent were found to be D+. Of these, 55.02 percent were of the phenotype CCDee. The Du phenotype was found to be present in 0.016 percent. Among the 0.27 percent who were apparently D-, 0.079 percent were of the Del phenotype, while the remaining 0.19 percent were "true D-," as defined by a nonreactive eluate obtained by an adsorption and elution procedure using anti-D. The ccdee phenotype constitutes 56.77 percent of the "apparent D-" and 80.24 percent of the true D-. Data show that anti-D rarely occurs in Hong Kong Chinese, and it is postulated that this could be due to the presence of a very weak form of the D antigen among many of those who appear to be D-.     

HIV risk behaviors associated with the injection process: multiperson use of drug injection equipment and paraphernalia in injection drug user networks

This study examines drug acquisition and multiperson use of paraphernalia, drugs, and needles/syringes. Ethnographers observed 54 injection episodes in which IDUs were linked by HIV risk behaviors, and developed a typology of higher-risk, lower-risk, and nonsharing-risk networks. Multiperson use of injection paraphernalia or drug solution occurred in most injection events (94%). Serial use of syringes/needles occurred infrequently (14%) relative to "backloading" (37%) and reuse of paraphernalia (cookers 84%, cotton 77%, water 77%). Higher-risk injection networks were characterized by larger size and pooling of resources for drugs. Prevention messages must include avoiding reuse of injection paraphernalia and transfer of drug solution.     

Declining seroprevalence in a very large HIV epidemic: injecting drug users in New York City, 1991 to 1996

OBJECTIVES: This study assessed recent trends in HIV seroprevalence among injecting drug users in New York City. METHODS: We analyzed temporal trends in HIV seroprevalence from 1991 through 1996 in 5 studies of injecting drug users recruited from a detoxification program, a methadone maintenance program, research storefronts in the Lower East Side and Harlem areas, and a citywide network of sexually transmitted disease clinics. A total of 11,334 serum samples were tested. RESULTS: From 1991 through 1996, HIV seroprevalence declined substantially among subjects in all 5 studies: from 53% to 36% in the detoxification program, from 45% to 29% in the methadone program, from 44% to 22% at the Lower East Side storefront, from 48% to 21% at the Harlem storefront, and from 30% to 21% in the sexually transmitted disease clinics (all P < .002 by chi 2 tests for trend). CONCLUSIONS: The reductions in HIV seroprevalence seen among injecting drug users in New York City from 1991 through 1996 indicate a new phase in this large HIV epidemic. Potential explanatory factors include the loss of HIV-seropositive individuals through disability and death and lower rates of risk behavior leading to low HIV incidence.