HIV, HCV, HBV Infections Prevalence among Heroin Addicts in the Central Region of Saudi Arabia - Article Example

HIV, HCV, HBV Infections Prevalence among Heroin Addicts in the Central Region of Saudi Arabia. Abdulaziz T. Alshomrani; Psychiatry , College of Medicine at Al Imam Mohammad Ibn Saud Islamic university Riyadh, Saudi Arabia Abstract Objective: In Saudi Arabia, a very few literatures dealt with the problem of HIV, HBV and HCV infections in Saudi addicts who inject drugs. Present study aimed to calculate prevalence of HBV, HCV and HIV infections among inpatient heroin addicts in Saudi central region and to study the relationship between these infections and patientss demographic variables. Method: Patients’ data had been collected from Alamal hospital in Riyadh, which is the only addiction treatment center in the central Saudi region and serve more than one fourth of Saudi population. All patients admitted to inpatient services are screened of HIV antibody, HBV service antigen, HCV antibody and, if positive, further confirmatory tests are done in central laboratory of Ministry of Health. In this study, I have reviewed heroin addict inpatients’ records whom were admitted between January 2006 and November 2012. HIV, HBV, HCV screening results, age, number of admission, education, marital and occupational status were collected. Prevalence of HIV, HBV and HCV and the associations between demographic variables and testing positive for these viruses were studied. Results: 378 inpatient files were analyzed. All patients were male with mean age of 40 (±8.6), and their lifetime number of admissions to addiction treatment centers were 5.8 times (±5). Screening results revealed that 20.1% of subjects had no viral infections, 56.6% had single viral infection, 13.2% were infected by two viruses and 1.1% was infected by three viruses. Prevalence of HBV, HCV and HIV are 7.7%, 77.8% and 9.8% respectively. There was a significant correlation between testing positive for HCV and HIV. Furthermore, Testing positive for HCV was more common among patients at age interval [20 – 29], unemployed and who had primary, secondary or postsecondary diploma level of education. HBV seropositive was associated with age intervals [30 – 39] and with secondary school level of education. Conclusion: This study proves that contracting serious contagious viral infection is very common among Saudi heroin addicts who inject drugs and are similar to those among addicts in Western countries. Infection control, education and harm reduction programs are of paramount importance in dealing with this problem. Opioid maintenance medication is not available in Saudi Arabia and even naltrexone medication as well, though this model of intervention could be of a great help in dealing with such an issue. Keywords: HIV, HBV, HCV, prevalence, demographic variables Introduction Substance users are more vulnerable to human immunodeficiency virus HIV and viral hepatitis than the general population [1-3]. Furthermore, those who inject drugs (IDUs) are at more high risk to catch HIV, hepatitis B virus and hepatitis C virus infections [1]. As these viruses are Blood borne infections, they are transmitted efficiently through sharing of contaminated needles and other injection paraphernalia [4-7]. In the United States, approximately 9%–12% of new HIV cases [8,9] and 50% of new hepatitis C cases [10] are associated with illicit injection of drugs. The prevalence of HCV virus among injecting drug users in industrial world is over than 60% [1-5]. Njoh and Zimmos described more than two thousand IUDs admitted to addiction treatment centre in Jeddah between January 1995 and May 1996 and found a 0.14% prevalence of HIV[11]. In another study done by the same researchers in 1996, they reported a prevalence of HCV seropositive at 74.6% [12].HBV service antigen were positive in 12.6% of screened 349 patient were 80% of them injecting drugs at the same center in 1995 [13].another screening done for 344 Saudi injecting drug at eastern region, reported a 38% HCV RNA detection rate and 12% detectable HBV DNA [14]. No studies done to estimate prevalence of these viral infections in the central region and even the studies done in Jeddah (western region) are too old and may not reflect correctly the current status. In this study we aim to estimate the prevalence of HBV, HCV and HIV infections among heroin addicts in Saudi central region and to explore any significant relationship related to patients’ demographic characteristics. Materials and Methods Participants Patients’ data had been collected from Alamal hospital in Riyadh, which is the only addiction treatment centre in the central Saudi region and serve more than one fourth of Saudi population. All patients whom admitted to inpatient services are screened of HIV antibody, HBV service antigen and HCV antibody through immunoassay methods. in case of positive results, a further confirmatory tests done in an the central laboratory of ministry of health which are, western blot test for HIV, HbsAg neutralization test for HBV and recombinant immunoassay (RIBA) for HCV. Design In this study, I have reviewed heroin addict inpatient’s records whom were admitted between January 2006 and November 2012. HIV, HBV, HCV results, age, number of admission, education, marital and occupational status were collected. Prevalence of HIV, HBV and HCV and the associations between demographic variables and testing positive for these viruses were studied. This article presents a review of heroin addicts’ records for patients who were admitted between January 2006 and November 2012. Details on HIV, HBV, HCV results, age, admission number, and education, marital & occupational status were collected. Prevalence of HIV, HBV & HCV and the associations between demographic variables and testing positive for these viruses were studied (Saxena, et al., 2003). Statistical Analysis Data were collected and stored in Microsoft Excel 2007® then managed and analyzed using SPSS® version 20.0 (IBM Inc., Chicago, Illinois, USA). Descriptive analysis was done, where categorical variables were presented as frequencies and percentages while continuous variables as mean (±SD). Chi2 test was used to detect the potential associations between presence of different viruses and socio-demographic variables (Fisher Exact test whenever indicated).. The Pearson correlation coefficient () was also used to detect the potential correlation among different variables. A confidence interval level was set to 95% where a corresponding p value threshold was identified as 0.05 where any output p below 0.05 would be interpreted as an indicator of statistical significance. Results A total of 378 subjects in the mean age of 40 (±8.6) ranging from [13 to 71] years were recruited in the current study. Average previous admissions to addiction treatment centers were 5.8 (±5). The majority of subjects were in the age interval of [40 – 49]; (43.1%). Analysis of demographic and socioeconomic characteristics showed that most of the recruited subjects were single (49.9%). Most of subjects had an intermediate and primary level of education (34.8% and 31.6% respectively). In terms of occupation, the majority were unemployed (69.1%) (Table 1). Screening results revealed that 20.1% of subjects have no viral infections, 56.6% have single viral infection, 13.2% were infected by two viruses and 1.1% was infected by 3 viruses. The prevalence of HCV seropositive among them was 77.8%, while HIV was 9.8% and HBV was 7.7%. Moreover, there is a significant correlation between HCV and HIV (R = 0.16, p = 0.003) while there is also a reverse significant correlation between HCV infection and number of admissions (R = -0.34, p Read More