Prevalence and correlates of co-infection with human immunodeficiency virus and hepatitis C virus in male injection drug users in Iran.

OBJECTIVE: Aim of the study was to evaluate the HIV and hepatitis C virus (HCV) coinfection and associated risk behaviors among Injection Drug Users in Detention, Tehran, Iran. METHODS: A cross-sectional survey included 499 male Injection Drug Users arrested by police during a predetermined police sweep in Tehran (February, 2006). At the temporary detention center, they were screened using a urine test and a physical examination for injection marks. Those who were identified as injectors were sent to the rehabilitation center for 3 months. A questionnaire was filled out for each individual by interview. Blood specimens were collected for HIV and HCV testing. The variables associated with HIV/HCV coinfection at a significance level of P<0.10 were considered in multivariate analysis. RESULTS: Of the 417 participants, 100 (24.0%) had HIV/HCV coinfection (95%CI 19.9 - 28.4). Factors independently associated with HIV/HCV coinfection included history of using opioid in jail, and age (P<0.05). There were not any association between other demographic characteristics (marital status, birthplace, residence, and education), type and years of drug abuse, age of first injection, years of injection, sharing needles inside and outside of jail, injection in jail, history of tattooing, any sexual behavior, and history of sexually transmitted diseases with HIV/HCV coinfection (P>0.05). CONCLUSIONS: This study supports that incarceration is contributing to the increased spread of HIV/HCV coinfection. So, there is urgent need for effective harm reduction programs, particularly among incarcerated Injection Drug Users.

Prevalence and correlates of hepatitis C infection among male injection drug users in detention, Tehran, Iran.

For the benefit of planning for the future care and treatment of people infected with hepatitis C virus (HCV) and to help guide prevention and control programs, data are needed on HCV seroprevalence and associated risk factors. We conducted a cross-sectional sero-behavioral survey of injection drug users (IDU) detained for mandatory rehabilitation during a police sweep of Tehran, Iran, in early 2006. During the study period, a consecutive sample comprising 454 of 499 (91.0%) men arrested and determined to be IDU by urine test and physical examination consented to a face-to-face interview and blood collection for HCV antibody testing. Overall, HCV prevalence was 80.0% (95% confidence interval (CI) 76.2-83.6). Factors independently associated with HCV infection included history of incarceration (adjusted OR 4.35, 95% CI 1.88-10.08), age of first injection < or =25 years (OR 2.72, 95% CI 1.09-6.82), and history of tattooing (OR 2.33, 95% CI 1.05-5.17). HCV prevalence in this population of IDU upon intake to jail was extremely high and possibly approaching saturation. Findings support that incarceration is contributing to the increased spread of HCV infection in Iran and calls for urgent increased availability of HCV treatment, long-term preparation for the care of complications of chronic infection, and rapid scale-up of programs for the primary prevention of parenterally transmitted infections among drug users.