Seroprevalence of Bartonella spp., Coxiella burnetii, and Hantavirus among people who inject drugs in Rio de Janeiro, Brazil: a retrospective assessment of a biobank.

The increasing use of illicit drugs imposes a public health challenge worldwide. People who inject drugs (PWID) are more susceptible to health complications due to immunosuppression associated with drug use and non-hygienic self-administration of substances, contaminants, and liquids. PWID are subjected to increased risk of acquiring and transmitting different pathogens (frequently functioning as sentinel cases for (re)emerging pathogens), including those transmitted by arthropods and vertebrate reservoirs in unhealthy environments. A clear association between injection drug use and HIV, HBV, and HCV infections has been described; however, other infectious viral and bacterial agents have been seldomly assessed. In this study, we investigated the seroprevalence of Bartonella spp., Coxiella burnetii, and Hantavirus among 300 randomly selected PWIDs from Rio de Janeiro, as part of a multi-city cross-sectional study carried out in the 1990s. Point seroprevalences and respective 95% CIs are as follows: 9.3% for C. burnetii (95% CI: 6.0%-13.0%), 1.0% for Bartonella spp. (95% CI: 0.0%-3.0%), and 4.0% for Hantavirus (95% CI: 2.0%-7.0%). In addition to the blood-borne pathogens, the results of this study increase our knowledge on other transmissible infectious agents in PWID. The high seroprevalence of C. burnetii and Hantavirus found among PWID is intriguing and suggests the need to carry out prospective studies, including molecular analyses, to confirm these findings and allow a better understanding of the putative relevance of these zoonotic infectious agents among PWID.

Soroprevalência de Bartonella sp., Coxiella burnetii e Hantavirus em Pessoas que Injetam Drogas Ilícitas no Estado do Rio de Janeiro nos anos de 1999 a 2001 / Seroprevalence of bartonella sp., coxiella burnetti and hantavirus in intravenous illicit drug users in the state of Rio de Janeiro in the years of 1999-2001

O aumento do consumo de drogas ilícitas na atualidade vem acompanhado não apenas do impacto social e econômico, como também na saúde. As pessoas que injetam drogas apresentam maior susceptibilidade a infecções por diversos agentes, devido ao uso da droga e à subsequente imunossupressão, como também pelo risco de maior exposição a agentes transmitidos por artrópodes e reservatórios vertebrados em ambientes insalubres. São muitos os estudos correlacionando o consumo de drogas à infecção pelo HIV, VHB e VHC, porém raros investigam outros agentes. No presente estudo transversal e retrospectivo, selecionamos aleatoriamente 300 amostras de um estudo multicêntrico da década de 1990 e fizemos a pesquisa sorológica para Bartonella spp., Coxiella burnetii e Hantavirus. O perfil demográfico e social encontrado mostrou-se em concordância com a literatura: homens, jovens, de baixa renda e com histórico de prisão. A maior parte apresentava situações de risco por injetar drogas com dispositivos previamente usados e por injetar em local público. Alguns fatores foram discordantes da literatura internacional e podem ter influenciado os resultados, uma vez que são considerados situações de risco, como escassez de pessoas que injetaram drogas enquanto presas, que residem em instituições, ou sem-tetoA evidência de infecção por C. burnetii foi de 9,3 porcento, praticamente o dobro da observada na população geral brasileira, embora, em comparação com dados internacionais, a prevalência tenha sido menor. Não houve diferença estatística significativa em relação às variáveis demográficas entre os grupos sororeativos e soronegativos para febre Q. A presença de anticorpos anti-Bartonella foi de 1 porcento, bem discrepante dos estudos nacionais e internacionais. Pode ser justificado pela não inclusão no teste sorológico de antígeno de B. elizabethae e de B. quintana e pela reduzida frequência de sem-tetos...

The increased consumption of illicit drugs today is followed not only by a social and economic impact, as well as in health. People who inject drugs are more susceptible to infections by various agents due to drug use and subsequent immunosuppression, as well as the risk of increased exposure to agents transmitted by arthropods and vertebrate reservoirs in unhealthy environments. Many studies link drug use to HIV, HBV and HCV,however only a few investigate other agents. In this retrospective cross-sectional study, we selected randomly 300 samples from a multicenter study from the 1990s and made aserological survey for Bartonella spp., Coxiella burnetii and hantavirus. The demographic and social profile was found in agreement with the literature: men, young age, low incomeand with a history of imprisonment. The majority was exposed to risk situations by injecting drugs with previously used devices and by injecting in a public places. Some factors were disagreeing with the international literature and may have influenced theresults, since they are considered high-risk situations, such as shortage of people whoinjected drugs while imprisoned, residing in institutions, or homeless. Evidence of C.burnetii infection was 9.3 percent, almost double the rate in the general Brazilian population,although in comparison with international data, the prevalence was lower. There was nostatistically significant difference in relation to demographic variables among seroreactiveand seronegative groups for fever Q. The presence of antibodies to Bartonella was 1percent, significantly discrepant from national/international studies. Possibly justified by the noninclusion of antigen B. elizabethae and B. quintana in the serological test, and the reduced frequency of homelessness. There was no correlation between high alcohol consumption with higher seroprevalence of Bartonella spp., probably for the reasons mentioned above...