A survey of hepatitis B and C prevalence amongst the homeless community of Prague.

BACKGROUND: Viral hepatitis B (VHB) and C (VHC) are a major health concern worldwide, with 170 million people chronically infected and at risk of liver cancer, cirrhosis or liver failure. Since no vaccination is available against VHC it is important to understand how to prevent future infection. The modes of transmission include intravenous drug use (IDU), blood products, tattooing and, to a lesser extent, sexual intercourse. Homelessness is a risk factor of VHB and VHC because of the environments and behaviours associated with homeless communities such as poor hygiene, nutrition and high levels of IDU. The aim of this project was to determine the prevalence of VHB and VHC and its risk factors amongst homeless community of Prague, Czech Republic. PATIENTS AND METHODS: Ninety-eight individuals of the Prague homeless community were interviewed and tested for VHB and VHC infection markers. RESULTS: The prevalence of both VHB and VHC was 26.5%. The major risk factors in this population were past and present IDU, young age and sharing the paraphernalia used by intravenous drug users (e.g. spoons, foils and filters). CONCLUSION: With the exception of age, all these risk factors could all be targeted in order to combat the major public health concern that VHB and VHC poses to the homeless community of Prague.

Short report: HIV infection among commercial sex workers and injecting drug users in the Czech Republic.

Since the first HIV case was diagnosed in the Czech Republic in 1985, there is a lack of information regarding the epidemiology of HIV infection in most high-risk groups. To determine the prevalence of, and risk factors for, HIV among female and male commercial sex workers (FCSW and MCSW, respectively) and injecting drug users (IDUs), cross-sectional studies were conducted in the cities of Cheb, Usti nad Labem, Ostrava, and Prague of the Czech Republic. A total of 1,277 subjects were enrolled, which included 585 FCSWs, 230 MCSWs, and 462 IDUs. The HIV prevalences were 0.7% (95% CI: 0.2-1.7%), 0.9% (95% CI: 0.1-3.1%), and 0.2% (95% CI: 0.005-1.2%) among FCSWs, MCSWs, and IDUs, respectively. Although low HIV prevalences were found, ongoing sentinel surveillance studies, which address modifiable behavioral and biologic risk factors among high-risk groups, are necessary to guide strategies to stem the tide of the epidemic in this country.