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Viral hepatitis in a Canadian street-involved population
S Moses1, K Mestery, K D E Kaita
1Public Health Branch, Manitoba Health, Departments of Medical Microbiology, Medicine and Community Health Sciences, University of Manitoba, Winnipeg, MB.
Insights
Viral hepatitis, including Hepatitis A (HAV), B (HBV), and C (HCV), is common in street-involved individuals. Vaccination for HBV is highly achievable, but long-term treatment compliance remains a concern.
Area of Science:
- Public Health
- Infectious Diseases
- Epidemiology
Background:
- Limited data exists on viral hepatitis prevalence and management within the street-involved population.
- Viral hepatitis poses a significant health burden in vulnerable communities.
Purpose of the Study:
- To determine the prevalence of Hepatitis A (HAV), B (HBV), and C (HCV) infections.
- To assess compliance with Hepatitis B (HBV) vaccination protocols.
- To identify risk factors associated with viral hepatitis infections in this demographic.
Main Methods:
- Conducted serologic testing for HAV, HBV, and HCV in 533 street-involved individuals.
- Documented compliance rates for a three-step HBV vaccination regimen.
- Analyzed associations between infections, vaccination compliance, and demographic/behavioral factors.
Main Results:
- Prevalence of HAV, HBV, and HCV infections were 53%, 12%, and 17% respectively.
- HAV infections linked to Aboriginal/Metis ethnicity and age >25. HBV and HCV associated with injection drug use (IDU); HCV also with sex trade work and age >25.
- High compliance (98%) with initial HBV vaccination steps, decreasing with subsequent steps (77%, 63%).
Conclusions:
- HAV, HBV, and HCV are prevalent among urban street-involved populations.
- Successful HBV vaccination is feasible in most individuals, but long-term adherence to antiviral therapies may be challenging.
- Targeted public health interventions are needed to manage viral hepatitis in this high-risk group.
Background:
Data on the prevalence and compliance with management of viral hepatitis in the street-involved population are limited.
Method:
Hepatitis A (HAV), B (HBV) and C (HCV) serology and compliance with HBV vaccination were documented in 533 street-involved individuals.
Results:
The mean age of the study population was 25.7 years (range: 11-65) and 53% were female. Serologic evidence of HAV infection was present in 53%; HBV, 12% (3% ongoing infection); and HCV, 17%. HAV infections were associated with Aboriginal/Metis ethnicity and age over 25 years; HBV with injection drug use (IDU); and HCV with IDU, sex trade work and age over 25 years. Compliance with three-step HBV vaccination was 98%, 77% and 63%.
Conclusions:
HAV, HBV and HCV are common infections in urban street-involved persons. Successful HBV (and presumably HAV) vaccination can be achieved in the majority of this population, but concerns exist regarding compliance with more long-term, parenterally-based antiviral therapies.