Seroepidemiology and risk factors of Hepatitis B and C virus infections among drug users in Jakarta, Indonesia.

The number of drug users is markedly increased in recent times. Data were collected consecutively in Cipto Mangunkusumo Hospital and Mitra Menteng Abadi Hospital in Jakarta. HBsAg were examined using reverse passive hemaglutination assay (RPHA) and anti-HCV with dipstick method; both were from the laboratoium Hepatika, Mataram, Indonesia. In a 5 month period (March - August 1999) there were 203 cases of drug users. Most of them were male ( 185 cases or 91.1%) with a mean age of 21.2 ± 4.3 years. Mean age in starting to use the drug was 18.8 ± 4.0 years. The prevalence of anti-HCV and HBsAg positivity were 74.9% (151 cases) and 9.9% (19 cases), respectively. The prevalence of double infection was 7.4% (15 cases). Injection drug users (IDU) were 168 cases (84%). Extramarital sex was done by 62 cases (30.5%), but only 16 cases (8%) with more than one partner. Tattoo was found in 32 cases ( 15.8%). Multivariate analysis revealed that lDU and tattoo were the risk factors for anti-HCV positivity, with the OR of 9.15 (95% CI 3.28-5.53) and 13.24 (96% CI 1.6 - 109.55), respectively. No significant medical risk factor could be identified for HBsAg positivity. Double infection of HBV and HCV was found in 15 cases (7.4%). We concluded that the prevalence of HBV, HCV infection and double infection of HBV - HCV in drug users were high, with tattoo and injection drug usage as risk factors for hepatitis C virus infection.

Combination of interferon alfa-2b and ribavirin in relapsed or nonresponding chronic hepatitis C patients following interferon therapy.

Twenty six patients (pts) with chronic hepatitis C (CHC) who reLapsed or non-responded following.interferon (IFN) therapy were given lFN alfa-2b 3 MIU three times a week for 48 weeks in combination with Ribavirin 800-1000 mg daily 2I (80,8%) of the 26.pts completed the study consisted of 12 relapsers and 9 non-responders. Five pts dropped out due to drug adverse events in three pts and non-drug related reason in the other two. In the relapsed group complete response, relapse and sustained response rates were obtained in 9/12(75%), 2/2 (16,5%) and 7/12(58,3%) pts respectively. In the non- responding group, these figures were 3/9 (33,3%), 1/9(I1,1%), and 2/9(22,2%) pts, respectively. The most frequent adverse event was flu-like syndrome, which was found in 18 pts (85,7%). Combination therapy of IFN alfa-2b and ribavirin may induce sustained virological response in relapsed and non-responding CHC patients. This combination therapy is more effective for relapsers compared to for non-responders.