HIV and hepatitis B surveillance in First Nations alcohol and drug treatment centres in British Columbia, Canada, 1992-2000.

We provide ongoing HIV and Hepatitis B surveillance in residential First Nations alcohol and drug treatment centres in British Columbia, Canada. All clients entering the centres are offered confidential viral testing as part of an education program on sexually transmitted diseases. Participation is voluntary and approximately two thirds of clients choose to be tested. Information about risk factors for communicable disease and immunization status is not recorded. The testing program began in January 1992. As of September 2000, 2,345 people have been tested for HIV. Nine tested positive, giving a prevalence of 3.8 per 1,000 (95% confidence interval: 1.3 to 6.3 per 1,000), lower than among all British Columbians who choose to be tested (8.5 per 1,000). Also, 2,166 people were tested for hepatitis B surface antibody, 23% of these were positive, 10% were positive for hepatitis B core antibody (indicating prior infection with hepatitis B). Seven clients (3.2 per 1,000; 95% Cl: 0.8 to 5.6 per 1,000) were positive for hepatitis B surface antigen and are therefore presumed to be chronically infected. The prevalence of hepatitis B markers was intermediate between what has previously been found in high risk groups and that found in the general population.

Human T-lymphotropic virus type I and II infections in First Nations alcohol and drug treatment centres in British Columbia, Canada, 1992-2000.

Since 1992, prevalence data on HTLV-I and II have been collected as part of an ongoing viral seroprevalence study in clients of six First Nations alcohol and drug treatment centres in British Columbia, Canada. Prior studies indicate that the lifetime risk of clinical disease (neurologic or hematologic) resulting from HTLV-I infection is low (less than 5%) and HTLV-II to date has not been clearly associated with clinical disease. In 1993, the first cases of HTLV-I-associated myelopathy or tropical spastic paraparesis (HAM/TSP) were reported in four Aboriginal residents of British Columbia; these were the first reports of HTLV-I linked disease among Aboriginal persons in Canada. All clients of the treatment centres involved in this study were offered confidential, voluntary testing following pre-test counseling, and the results are given to participants before the residential session is complete. 1953 men and women were tested; 11 were positive for HTLV-1 (0.56%) and 33 were positive for HTLV-2 (1.8%).