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Past infection with hepatitis A virus among Vancouver street youth, injection drug users and men who have sex with men: implications for vaccination programs.
CMAJ. 2001 Aug 07; 165(3):293-7.CMAJ

Abstract

BACKGROUND

In Canada, inactivated hepatitis A vaccines are targeted selectively at those at increased risk for infection or its complications. In order to evaluate the need for routine hepatitis A vaccination programs in Vancouver for street youth, injection drug users (IDUs) and men who have sex with men (MSM), we determined the prevalence of antibodies against hepatitis A virus (HAV) and risk factors for HAV in these groups.

METHODS

The frequency of past HAV infection was measured in a sample of Vancouver street youth, IDUs and MSM attending outreach and STD clinics and needle exchange facilities by testing their saliva for anti-HAV immunoglobulin G. A self-administered, structured questionnaire was used to gather sociodemographic data. Stepwise logistic regression was used to evaluate the association between presumed risk factors and groups and past HAV infection.

RESULTS

Of 494 study participants, 235 self-reported injection drug use, 51 were self-identified as MSM and 111 met street youth criteria. Positive test results for anti-HAV were found in 6.3% of street youth (95% confidence interval [CI] 2.6%-12.6%), 42.6% (95% CI 36.2%-48.9%) of IDUs and 14.7% (95% CI 10.4%-19.1%) of individuals who denied injection drug use. Among men who denied injection drug use, the prevalence was 26.3% (10/38) for MSM and 12% (21/175) for heterosexuals. Logistic regression showed that past HAV infection was associated with increased age and birth in a country with high rates of hepatitis infection. Injection drug use among young adults (25-34 years old) was a significant risk factor for a positive anti-HAV test (p = 0.009). MSM were also at higher risk for past HAV infection, although this association was nominally significant (p = 0.07).

INTERPRETATION

Low rates of past HAV infection among Vancouver street youth indicate a low rate of virus circulation in this population, which is vulnerable to hepatitis A outbreaks. An increased risk for HAV infection in IDUs and MSM supports the need to develop routine vaccination programs for these groups also.

Authors+Show Affiliations

Vaccine Evaluation Center, British Columbia's Children's Hospital and University of British Columbia. jochnio@interchange.ubc.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11517645

Citation

Ochnio, J J., et al. "Past Infection With Hepatitis a Virus Among Vancouver Street Youth, Injection Drug Users and Men Who Have Sex With Men: Implications for Vaccination Programs." CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, vol. 165, no. 3, 2001, pp. 293-7.
Ochnio JJ, Patrick D, Ho M, et al. Past infection with hepatitis A virus among Vancouver street youth, injection drug users and men who have sex with men: implications for vaccination programs. CMAJ. 2001;165(3):293-7.
Ochnio, J. J., Patrick, D., Ho, M., Talling, D. N., & Dobson, S. R. (2001). Past infection with hepatitis A virus among Vancouver street youth, injection drug users and men who have sex with men: implications for vaccination programs. CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, 165(3), 293-7.
Ochnio JJ, et al. Past Infection With Hepatitis a Virus Among Vancouver Street Youth, Injection Drug Users and Men Who Have Sex With Men: Implications for Vaccination Programs. CMAJ. 2001 Aug 7;165(3):293-7. PubMed PMID: 11517645.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Past infection with hepatitis A virus among Vancouver street youth, injection drug users and men who have sex with men: implications for vaccination programs. AU - Ochnio,J J, AU - Patrick,D, AU - Ho,M, AU - Talling,D N, AU - Dobson,S R, PY - 2001/8/24/pubmed PY - 2001/9/8/medline PY - 2001/8/24/entrez SP - 293 EP - 7 JF - CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne JO - CMAJ VL - 165 IS - 3 N2 - BACKGROUND: In Canada, inactivated hepatitis A vaccines are targeted selectively at those at increased risk for infection or its complications. In order to evaluate the need for routine hepatitis A vaccination programs in Vancouver for street youth, injection drug users (IDUs) and men who have sex with men (MSM), we determined the prevalence of antibodies against hepatitis A virus (HAV) and risk factors for HAV in these groups. METHODS: The frequency of past HAV infection was measured in a sample of Vancouver street youth, IDUs and MSM attending outreach and STD clinics and needle exchange facilities by testing their saliva for anti-HAV immunoglobulin G. A self-administered, structured questionnaire was used to gather sociodemographic data. Stepwise logistic regression was used to evaluate the association between presumed risk factors and groups and past HAV infection. RESULTS: Of 494 study participants, 235 self-reported injection drug use, 51 were self-identified as MSM and 111 met street youth criteria. Positive test results for anti-HAV were found in 6.3% of street youth (95% confidence interval [CI] 2.6%-12.6%), 42.6% (95% CI 36.2%-48.9%) of IDUs and 14.7% (95% CI 10.4%-19.1%) of individuals who denied injection drug use. Among men who denied injection drug use, the prevalence was 26.3% (10/38) for MSM and 12% (21/175) for heterosexuals. Logistic regression showed that past HAV infection was associated with increased age and birth in a country with high rates of hepatitis infection. Injection drug use among young adults (25-34 years old) was a significant risk factor for a positive anti-HAV test (p = 0.009). MSM were also at higher risk for past HAV infection, although this association was nominally significant (p = 0.07). INTERPRETATION: Low rates of past HAV infection among Vancouver street youth indicate a low rate of virus circulation in this population, which is vulnerable to hepatitis A outbreaks. An increased risk for HAV infection in IDUs and MSM supports the need to develop routine vaccination programs for these groups also. SN - 0820-3946 UR - https://www.unboundmedicine.com/medline/citation/11517645/Past_infection_with_hepatitis_A_virus_among_Vancouver_street_youth_injection_drug_users_and_men_who_have_sex_with_men:_implications_for_vaccination_programs_ L2 - http://www.cmaj.ca/cgi/pmidlookup?view=long&pmid=11517645 DB - PRIME DP - Unbound Medicine ER -