Theme: Epidemiology & Public Health Research Year: 2024
Background: Despite the serious effects of unmanaged hepatitis B and delta virus infections (HBV and HDV), knowledge about their prevalence and efforts to ensure diagnosis and connection to care among people who use drugs (PWUD) remain limited. This study assessed HBV and HDV prevalence and facilitated linkage to vaccination or care at a Philadelphia, PA (USA) harm reduction organization (HRO).
Methods: Participants completed a demographic/risk factors survey and blood draw to assess HBV immunity and infection, with reflex for HDV if HBV surface antigen (current infection) or isolated core antibody (previous exposure) were present. Participants were incentivized for testing and to return to review results with study staff, where linkage to immunization and care were attempted. Fisher’s exact tests and regression were used to identify relationships between risk factors and HBV blood markers.
Results: Of the 498 participants, 126 (25.3%) were susceptible to HBV, 52.6% were vaccinated, and 17.9% had recovered from past infection. Eleven (2.2%) tested positive for isolated HBV core antibody, 10 (2.0%) for HBV surface antigen, and one for HDV antibody. History of incarceration was associated with current HBV infection, while transactional sex and experience of homelessness were associated with previous HBV exposure.
Conclusion: Rates of current HBV infection in this study were nearly three times greater than the general US population. Despite availability of vaccine, 25% remained vulnerable to infection. Linking participants to immunization and care was complicated by provider restrictions and logistical challenges. These results demonstrate the need to improve low-threshold screening, vaccination, and linkage to care among PWUD, and how tools like point-of-care diagnostics and increased support for HROs can fill gaps in the HBV/HDV care cascade. From this presentation, conference attendees will gain insights into the problem of HBV/HDV among PWUD, and strategies for improving diagnosis and connection to care and prevention.
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