A window of opportunity: declining rates of hepatitis B virus infection among injection drug users in Rio de Janeiro, and prospects for targeted hepatitis B vaccination.

OBJECTIVES: To measure hepatitis B virus (HBV) infection rates among injection drug users in Rio de Janeiro, Brazil, and to report their knowledge of and attitudes toward hepatitis and HBV vaccination. METHODS: 609 injection drug users recruited in Rio de Janeiro between 1999 and 2001 answered a questionnaire and were tested for hepatitis B and other blood-borne infections. Questions covered sociodemographic information, alcohol and illicit drug consumption, drug injection and sexual practices, medical history, and knowledge about HIV, AIDS and viral hepatitis. RESULTS: The prevalence of HBV infection was 27.1%, with 3.4% of the sample positive for HbsAg (active infection) and 0.8% positive for anti-HBs (indicating previous HBV vaccination). Most interviewees (81.3%) were aware of at least one form of viral hepatitis and received information from many different sources. In agreement with laboratory findings, 96.7% of the interviewees stated they had never been vaccinated against hepatitis B, but almost all unvaccinated interviewees (97.8%) said they would volunteer to be vaccinated if HBV vaccination were available. CONCLUSIONS: Few of the injection drug users surveyed had ever been vaccinated against HBV. Although most were aware of the risks posed by viral hepatitis, this awareness seldom translated into consistent behavioral change. The participants' willingness to be vaccinated against HBV suggests that the implementation of vaccination for this population may help decrease rates of hepatitis B infection.

A window of opportunity: declining rates of hepatitis B virus infection among injection drug users in Rio de Janeiro, and prospects for targeted hepatitis B vaccination / Ventana de oportunidad: reducción de las tasas de infección por el virus de la hepatitis B entre usuarios de drogas inyectadas en Río de Janeiro, Brasil, y planes futuros en torno a la vacunación contra la hepatitis B

OBJETIVOS: Calcular las tasas de infección por el virus de la hepatitis B (VHB) en usuarios de drogas inyectadas en Río de Janeiro, Brasil, y dar a conocer sus conocimientos y actitudes en torno a la hepatitis y a la vacunación contra el VHB. MÉTODOS: Seiscientos nueve usuarios de drogas que se reclutaron en Río de Janeiro entre 1999 y 2001 respondieron a un cuestionario y fueron sometidos a pruebas para detectar la presencia de hepatitis B y de otras infecciones transmitidas por la sangre. Las preguntas versaban sobre aspectos sociodemográficos, el consumo de alcohol y de drogas ilícitas, el modo de inyección de las drogas y las prácticas sexuales, los antecedentes médicos y los conocimientos sobre el VIH, el sida y la hepatitis viral.RESULTADOS: La prevalencia de infección por el VHB fue de 27,1%; 3,4% de la muestra tuvo resultados positivos al HB Ag (infección activa) y 0,8% a anticuerpos anti-HBs (indicadores de que ya se ha recibido la vacuna contra el VHB). La mayor parte de las personas entrevistadas afirmaron no haber sido vacunadas contra la hepatitis B, pero casi todos las que no habían recibido la vacuna (97,8%) manifestaron estar dispuestas a vacunarse si se elaborase una vacuna. CONCLUSIONES: Pocos de los usuarios de drogas inyectadas habían sido vacunados contra el VHB. Aunque la mayor parte eran conscientes de los peligros que acarrea la hepatitis viral, ello raras veces se traducía en un cambio conductual invariable. La disposición de los participantes a vacunarse contra el VHB indica que si se implementase la vacunación en esta población se lograría reducir las tasas de hepatitis B.

Objectives. To measure hepatitis B virus (HBV) infection rates among injection drug users in Rio de Janeiro, Brazil, and to report their knowledge of and attitudes toward hepatitis and HBV vaccination. Methods. 609 injection drug users recruited in Rio de Janeiro between 1999 and 2001 answered a questionnaire and were tested for hepatitis B and other blood-borne infections. Questions covered sociodemographic information, alcohol and illicit drug consumption, drug injection and sexual practices, medical history, and knowledge about HIV, AIDS and viral hepatitis. Results. The prevalence of HBV infection was 27.1% , with 3.4% of the sample positive for HbsAg (active infection) and 0.8% positive for anti-HBs (indicating previous HBV vaccination). Most interviewees (81.3%) were aware of at least one form of viral hepatitis and received information from many different sources. In agreement with laboratory findings, 96.7% of the interviewees stated they had never been vaccinated against hepatitis B, but almost all unvaccinated interviewees (97.8%) said they would volunteer to be vaccinated if HBV vaccination were available. Conclusions. Few of the injection drug users surveyed had ever been vaccinated against HBV. Although most were aware of the risks posed by viral hepatitis, this awareness seldom translated into consistent behavioral change. The participants' willingness to be vaccinated against HBV suggests that the implementation of vaccination for this population may help decrease rates of hepatitis B infection