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Multiple modes of hepatitis A virus transmission among methamphetamine users
Y J Hutin1, K M Sabin, L C Hutwagner
1Hepatitis Branch, Division of Viral and Rickettsial Disease, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Abstract:
Methamphetamine users are at increased risk of hepatitis A, but modes of transmission are unclear. The authors conducted a case-control study among methamphetamine users during an outbreak in Iowa in 1997. Twenty-eight reported, laboratory-confirmed, hepatitis A cases did not differ from 18 susceptible controls with respect to age, sex, or number of doses used. When compared with controls in multivariate analysis, case-patients were more likely to have injected methamphetamine (odds ratio (OR) = 5.5, 95% confidence interval (CI): 1.1, 27), to have used methamphetamine with another case-patient (OR = 6.2, 95% CI: 0.95, 41), and to have used brown methamphetamine (OR = 5.5, 95% CI: 0.51, 59). Receptive needle sharing was reported by 10 of the 20 case-patients who injected. Methamphetamine use with another case-patient was also associated with hepatitis A in an analysis restricted to noninjectors (OR = 17, 95% CI: 1.0, 630). During this outbreak, hepatitis A may have been transmitted from person to person among methamphetamine users through the fecal-oral and the percutaneous routes. Methamphetamine users should be vaccinated against hepatitis A and should be given immune globulin if they used methamphetamine with a case-patient in the last 2 weeks. Persons who intend to continue using methamphetamine should be advised about safer practices.
Insights
Hepatitis A transmission among methamphetamine users may occur through injection, sharing drug paraphernalia, or close contact. Vaccination and immune globulin are recommended for methamphetamine users, along with safer practices.
Area of Science:
- Hepatology
- Infectious Diseases
- Public Health
Background:
- Methamphetamine users face elevated risks for Hepatitis A infection.
- Understanding transmission routes is crucial for prevention efforts.
Purpose of the Study:
- To investigate the transmission modes of Hepatitis A among methamphetamine users during an outbreak.
- To identify risk factors associated with Hepatitis A infection in this population.
Main Methods:
- A case-control study was conducted among methamphetamine users in Iowa during a 1997 outbreak.
- Laboratory-confirmed Hepatitis A cases were compared with susceptible controls.
Main Results:
- Injecting methamphetamine (OR=5.5) and using with another case-patient (OR=6.2) were significantly associated with Hepatitis A.
- Receptive needle sharing was reported by half of injecting case-patients.
- Among non-injectors, methamphetamine use with another case-patient showed a strong association (OR=17).
Conclusions:
- Hepatitis A transmission among methamphetamine users likely occurs via fecal-oral and percutaneous routes.
- Vaccination and immune globulin are recommended for methamphetamine users exposed to the virus.
- Advising on safer practices is essential for individuals continuing methamphetamine use.