[Prevalence of HIV and hepatitis B and C among drug addicts in the city of Copenhagen]. / Udbredelsen af hiv og hepatitis B og C blandt københavnske stofmisbrugere.

Blood samples were drawn from 291 drug users attending methadone clinics throughout 1997 and interviews performed about associated risk factors for seroconversion. The overall prevalence of HIV was 3.4%. Sixty-four percent tested positive for HBV and 75% for HCV. Almost all with a ten year history of drug use acquired one or more of the infections, including those who reported not to have injected. Among the sexually active 54% never used a condom and 14% of the injectors had shared needles within the last six months. Prevention measures contributing to the low prevalence of HIV had apparently no effect on transmission of hepatitis B and C. The findings call for more focus on hepatitis prevention including information, counselling, testing and vaccination.

Haemophilic patients with hepatitis C have higher viral load compared to other well-defined patient groups.

Comparison of hepatitis C viral load between different patient populations has been hampered by the use of different technology in individual studies. We had the impression that haemophilic (HAEM) patients had a higher serum load of hepatitis C virus (HCV) compared to other HCV-infected patients. We therefore studied viral load and genotypes in active illicit drug users (IDU), HAEM patients and patients with post-transfusion hepatitis (PTH). The study comprises 225 HCV-RNA positive patients, 117 IDU, 60 HAEM patients and 48 PTH patients. All patients were anti-HIV negative. HCV-RNA was measured with a quantitative reverse transcription polymerase chain reaction (RT-PCR) method, HCV-genotypes were determined with genotype specific primers in RT-PCR in 221 patients. Four patients could not be genotyped with our assay and were excluded. Overall viral load was higher in genotypes 1 and 2 compared to genotype 3, median values of HCV-RNA were 1,400 x 10(3) geq ml(-1), 2,700 x 10(3) geq ml(-1) and 270 x 10(3) geq ml(-1), respectively. HAEM patients had significantly higher viral load for both genotypes 1 and 3 compared to the IDU and PTH patients. In a multiple linear regression model HCV-RNA viral load was independently associated with HAEM and genotype, but not to age, gender or disease duration. In conclusion, HAEM patients have higher viral load than IDU and PTH patients. The reason for this is unknown, but it may be due to host factors or mode of transmission with multiple inoculations.