Seroprevalence of hepatitis B markers among incarcerated intravenous drug users

Drug injection is one of the most prominent risk factors for transmission of viral hepatitis. Prevalence of hepatitis B virus (HBV) is generally higher in prisoners compared with the general population. The object of this study was to assess the markers of HBV and related risk factors among intravenous drug users (IVDU) in prisoners.

Through a cross-sectional study in 2012 HBV infection and its risk factors were assessed in prisoners with a history of intravenous drug use in Isfahan, Iran. A checklist was fulfilled for each participant and 5 ml blood was taken from each subject. Sera were analyzed for markers of the hepatitis B: Hepatitis B virus surface antigen (HBsAg), antibody to hepatitis B virus surface antigen (HBsAb) and hepatitis B virus core antibody (HBcAb) by ELISA. We used Chi-square test and logistic regression model to analyze data and P < 0.05 was considered to be significant.

All of the studied participants (n = 970) were men. The mean ± standard deviation of the age of the subjects was 32.61 ± 8.1 years and the majority of them had less than high school education. More than 40% of these men had a history of injection drug inside prison and 2.27% of them self-reported history of HBV infection. Of the 970 IVDU, 32 (3.3%) were positive for HBsAg. Among HBsAg + subjects, 23 (71.88%) were HBcAb+. 120 (12.37%) were found positive for isolated HBsAb, 45 (4.64%) for isolated HBcAb and 67 (6.9%) for both HBsAb and HBcAb. History of sharing needle (odds ratio: 2.25, 95% confidence interval: 1.09-4.65) had a significant association with HBsAg positivity.

The results suggest that history of sharing needle had a significant association with HBsAg positivity. It seems that educational programs for injecting drug related behaviors, especially syringe sharing, are needed for IVDU.