Surveillance of HIV and Viral Hepatitis by Analysis of Samples from Drug Related Deaths |
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Authors: | Peer Brehm Christensen Birgitte Kringsholm Jytte Banner Jørgen L Thomsen Susan Cowan Gabriela Felicia Stein Gitte Wulf Jürgensen Kari Grasaasen Jørgen Georgsen Court Pedersen |
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Institution: | (1) Department of Infectious Diseases, Odense University Hospital, Odense C, DK5000, Denmark;(2) Institute of Forensic Medicine, Copenhagen University, Aarhus, Denmark;(3) Institute of Forensic Medicine, Aarhus University, Odense M, Denmark;(4) Institute of Forensic Medicine, University of Southern Denmark, Copenhagen, Denmark;(5) Department of Epidemiology, Statens Serum Institute, Copenhagen, Denmark;(6) Department of Clinical Immunology, Odense University Hospital, Odense, Denmark;(7) National Board of Health, Copenhagen, Denmark;(8) Department of Infectious Diseases, Odense University Hospital, DK5000 Odense C, Denmark |
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Abstract: | Objectives: To determine the prevalence of antibodies against HIV, hepatitis B (HBV) and hepatitis C (HCV) in postmortem samples from drug related deaths (DRDs) in Denmark.Design: Prospective cohort study. Postmortem samples tested for anti-HIV, anti-HCV anti-HBc and anti-HBs. Comparison to pre-mortem testing when possible. DRDs were searched for in the national register of drug treatment, national prison registers, and the national infectious disease register.Setting: National level.Participants: Drug related deaths admitted to Danish Institutes of Forensic Medicine during 2004.Main outcome measures: Prevalence of antibodies, injection drug use, drug treatment experience and prevalence of cirrhosis.Results: Samples for analysis were obtained from 78% (233/299) of DRDs. The prevalences of anti-HIV, anti-HCV and anti-HBc were 4% (9/214), 51% (110/215), and 35% (74/209), indicating a persisting low prevalence of HIV and a declining prevalence of HCV and HBV. Injecting ever was detected among 45% of DRDs and this was associated with a significantly higher prevalence of hepatitis B and C. Among the DRDs 56% received drug treatment and 12% had cirrhosis at autopsy. Evidence of vaccination against HBV was found among 16% (21/128).Conclusions: Monitoring of viral hepatitis and HIV among DRDs is feasible, and our survey indicates a falling prevalence among Danish drug users. Surveillance based on drug users in treatment may overestimate the true prevalence. |
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Keywords: | Drug related deaths Postmortem testing Viral hepatitis epidemiology |
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