Abstract
Intravenous drug users are frequently exposed to parenterally transmitted viral infections, and these infections can spread to the general population through sexual activity. We investigated the prevalence of serologic markers for human immunodeficiency virus type 1 (HIV-1), human T-cell lymphotropic virus type I/II (HTLV-I/II), hepatitis B virus (HBV), and hepatitis C virus (HCV) in intravenous drug users and their sexual contacts. Of 585 drug users from northern California tested for these serologic markers, 72% were reactive for the antibody to HCV, 71% for the antibody to hepatitis B core antigen, 12% for HTLV-I/II antibodies, and 1% for the HIV-1 antibody. The prevalence of serologic markers for these four viruses correlated with the duration of intravenous drug use, the ethnic group, and the drug of choice. More than 85% of subjects infected with either HCV or HBV were coinfected with the other virus. All persons reactive to HTLV-I/II antibodies had antibodies for either HBV or HCV. Of 81 sexual contacts tested, 17% had evidence of HBV infection while only 6% were reactive for HTLV-I/II antibodies and 4% for the antibody to HCV. None of this group was infected with HIV-1. We conclude that HTLV-I/II and HCV are inefficiently transmitted to sexual contacts while HBV is spread more readily. Programs designed to discourage the sharing of drug paraphernalia, such as needle and syringe exchanges, should decrease the risk of parenterally spread viral infections in intravenous drug users and thus slow the spread of these infections to the general population.
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- Blayney D. W., Blattner W. A., Robert-Guroff M., Jaffe E. S., Fisher R. I., Bunn P. A., Jr, Patton M. G., Rarick H. R., Gallo R. C. The human T-cell leukemia-lymphoma virus in the southeastern United States. JAMA. 1983 Aug 26;250(8):1048–1052. [PubMed] [Google Scholar]
- Carlson J. R., Yee J., Hinrichs S. H., Bryant M. L., Gardner M. B., Pedersen N. C. Comparison of indirect immunofluorescence and Western blot for detection of anti-human immunodeficiency virus antibodies. J Clin Microbiol. 1987 Mar;25(3):494–497. doi: 10.1128/jcm.25.3.494-497.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chaisson R. E., Moss A. R., Onishi R., Osmond D., Carlson J. R. Human immunodeficiency virus infection in heterosexual intravenous drug users in San Francisco. Am J Public Health. 1987 Feb;77(2):169–172. doi: 10.2105/ajph.77.2.169. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Des Jarlais D. C., Friedman S. R., Novick D. M., Sotheran J. L., Thomas P., Yancovitz S. R., Mildvan D., Weber J., Kreek M. J., Maslansky R. HIV-1 infection among intravenous drug users in Manhattan, New York City, from 1977 through 1987. JAMA. 1989 Feb 17;261(7):1008–1012. doi: 10.1001/jama.261.7.1008. [DOI] [PubMed] [Google Scholar]
- Des Jarlais D. C., Friedman S. R., Stoneburner R. L. HIV infection and intravenous drug use: critical issues in transmission dynamics, infection outcomes, and prevention. Rev Infect Dis. 1988 Jan-Feb;10(1):151–158. doi: 10.1093/clinids/10.1.151. [DOI] [PubMed] [Google Scholar]
- Esteban J. I., Esteban R., Viladomiu L., López-Talavera J. C., González A., Hernández J. M., Roget M., Vargas V., Genescà J., Buti M. Hepatitis C virus antibodies among risk groups in Spain. Lancet. 1989 Aug 5;2(8658):294–297. doi: 10.1016/s0140-6736(89)90485-6. [DOI] [PubMed] [Google Scholar]
- Everhart J. E., Di Bisceglie A. M., Murray L. M., Alter H. J., Melpolder J. J., Kuo G., Hoofnagle J. H. Risk for non-A, non-B (type C) hepatitis through sexual or household contact with chronic carriers. Ann Intern Med. 1990 Apr 1;112(7):544–545. doi: 10.7326/0003-4819-112-7-544. [DOI] [PubMed] [Google Scholar]
- Falloon J., Eddy J., Wiener L., Pizzo P. A. Human immunodeficiency virus infection in children. J Pediatr. 1989 Jan;114(1):1–30. doi: 10.1016/s0022-3476(89)80596-7. [DOI] [PubMed] [Google Scholar]
- Follett E. A., Wallace L. A., McCruden E. A. HIV and HBV infection in drug abusers in Glasgow. Lancet. 1987 Apr 18;1(8538):920–920. doi: 10.1016/s0140-6736(87)92893-5. [DOI] [PubMed] [Google Scholar]
- Hahn R. A., Onorato I. M., Jones T. S., Dougherty J. Prevalence of HIV infection among intravenous drug users in the United States. JAMA. 1989 May 12;261(18):2677–2684. [PubMed] [Google Scholar]
- Hartgers C., Buning E. C., van Santen G. W., Verster A. D., Coutinho R. A. The impact of the needle and syringe-exchange programme in Amsterdam on injecting risk behaviour. AIDS. 1989 Sep;3(9):571–576. doi: 10.1097/00002030-198909000-00003. [DOI] [PubMed] [Google Scholar]
- Koff R. S., Slavin M. M., Connelly J. D., Rosen D. R. Contagiousness of acute hepatitis B. Secondary attack rates in household contacts. Gastroenterology. 1977 Feb;72(2):297–300. [PubMed] [Google Scholar]
- Lange W. R., Snyder F. R., Lozovsky D., Kaistha V., Kaczaniuk M. A., Jaffe J. H. Geographic distribution of human immunodeficiency virus markers in parenteral drug abusers. Am J Public Health. 1988 Apr;78(4):443–446. doi: 10.2105/ajph.78.4.443. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lee H. H., Weiss S. H., Brown L. S., Mildvan D., Shorty V., Saravolatz L., Chu A., Ginzburg H. M., Markowitz N., Des Jarlais D. C. Patterns of HIV-1 and HTLV-I/II in intravenous drug abusers from the middle atlantic and central regions of the USA. J Infect Dis. 1990 Aug;162(2):347–352. doi: 10.1093/infdis/162.2.347. [DOI] [PubMed] [Google Scholar]
- Lee H., Swanson P., Shorty V. S., Zack J. A., Rosenblatt J. D., Chen I. S. High rate of HTLV-II infection in seropositive i.v. drug abusers in New Orleans. Science. 1989 Apr 28;244(4903):471–475. doi: 10.1126/science.2655084. [DOI] [PubMed] [Google Scholar]
- Magura S., Grossman J. I., Lipton D. S., Siddiqi Q., Shapiro J., Marion I., Amann K. R. Determinants of needle sharing among intravenous drug users. Am J Public Health. 1989 Apr;79(4):459–462. doi: 10.2105/ajph.79.4.459. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Marmor M., Des Jarlais D. C., Cohen H., Friedman S. R., Beatrice S. T., Dubin N., el-Sadr W., Mildvan D., Yancovitz S., Mathur U. Risk factors for infection with human immunodeficiency virus among intravenous drug abusers in New York City. AIDS. 1987 May;1(1):39–44. [PubMed] [Google Scholar]
- Murphy E. L., Figueroa J. P., Gibbs W. N., Brathwaite A., Holding-Cobham M., Waters D., Cranston B., Hanchard B., Blattner W. A. Sexual transmission of human T-lymphotropic virus type I (HTLV-I). Ann Intern Med. 1989 Oct 1;111(7):555–560. doi: 10.7326/0003-4819-111-7-555. [DOI] [PubMed] [Google Scholar]
- Robert-Guroff M., Weiss S. H., Giron J. A., Jennings A. M., Ginzburg H. M., Margolis I. B., Blattner W. A., Gallo R. C. Prevalence of antibodies to HTLV-I, -II, and -III in intravenous drug abusers from an AIDS endemic region. JAMA. 1986 Jun 13;255(22):3133–3137. [PubMed] [Google Scholar]
- Schoenbaum E. E., Hartel D., Selwyn P. A., Klein R. S., Davenny K., Rogers M., Feiner C., Friedland G. Risk factors for human immunodeficiency virus infection in intravenous drug users. N Engl J Med. 1989 Sep 28;321(13):874–879. doi: 10.1056/NEJM198909283211306. [DOI] [PubMed] [Google Scholar]
- Stimson G. V., Alldritt L., Dolan K., Donoghoe M. Syringe exchange schemes for drug users in England and Scotland. Br Med J (Clin Res Ed) 1988 Jun 18;296(6638):1717–1719. doi: 10.1136/bmj.296.6638.1717. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tirelli U., Vaccher E., Carbone A., De Paoli P., Santini G., Monfardini S. Heterosexual contact is not the predominant mode of HTLV-III transmission among intravenous drug abusers. JAMA. 1986 May 2;255(17):2289–2289. [PubMed] [Google Scholar]