Abstract
Hepatitis B virus (HBV) hepatitis is extremely common among problematic drug users (DUs). As of 2012, 47 of the 53 European countries had implemented a universal hepatitis B vaccination programme, a scenario that could radically change its spread. Even so, drug users are still one of the main groups at risk of being infected by HBV, exposing the fact that universal vaccination still has not managed to reach an optimal level of contagion protection. In order to evaluate the role of universal HBV vaccination in protecting against risk behaviour related to the use of illicit drugs, a group of 748 DUs, 511 male and 237 female, was tested for HBV markers, at their first access to public addiction clinics in the metropolitan area of Bologna, Italy. 487 were born after 1981, so they were eligible to have received HBV vaccination in adolescence or at birth; in these subjects antibodies against HBV core antigen had the significant prevalence of 6.2%. Universal HBV vaccination has shown evidence of protecting against infection in the general population. These results, amongst the first to evaluate actual protection in DUs vaccinated at birth or during adolescence, show that compulsory universal vaccination does not solve the problem of HBV transmission in the most at risk groups and that additional strategies must be studied and implemented to address this issue.
Highlights
IntroductionIllicit drug use and consequent infections are among the most significant problems in the world [1,2]
Illicit drug use and consequent infections are among the most significant problems in the world [1,2].Viral hepatitis is common among drug users (DUs), those who inject the drug [3,4,5,6,7], presenting relevant consequences in morbidity and mortality along with high social and economic cost [3,7,8,9,10,11]
Among the subjects that accessed Public Addiction Centres Centers (PACs) in 2012 (2588 DUs), 1679 DUs were excluded from the study because their Hepatitis B virus (HBV) serology had not been tested, and another 161 that had been tested but the results had not been registered
Summary
Illicit drug use and consequent infections are among the most significant problems in the world [1,2]. Viral hepatitis is common among drug users (DUs), those who inject the drug [3,4,5,6,7], presenting relevant consequences in morbidity and mortality along with high social and economic cost [3,7,8,9,10,11]. In DUs deaths from liver disease have increased significantly [12,13,14]. Chronic carriers have a 25% risk of dying from the consequences of HBV infection, such as cirrhosis and liver cancer [1,2,15]. Vaccination is the most effective measure to prevent HBV infections and related consequences [10,16,17]
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