Hepatitis B and D Diagnosis and Prevalence in People Who Use or Inject Drugs in ARUD, Centre for Addiction Medicine in Zurich.


Author: Claudia Bernardini, Lina Hijazi

Theme: Clinical Research Year: 2023

Background
Coinfection with both hepatitis B and hepatitis D significantly negatively impacts the individual’s clinical course and outcome. Early identification and treatment of hepatitis D coinfection is crucial. This retrospective study aims to ascertain the current prevalence of active Hepatitis B and D infection among individuals attending a low threshold integrated addiction and harm reduction clinic.

Methods
Combined retrospective searches of our clinical and the laboratory systems enabled us to develop a database of at-risk individuals and those screened for Hepatitis B and D infection. Analysis of this data enabled the calculation of current prevalence in our cohort and identification of high risk untested individuals.

Results
An initial review of our clinic data indicates that hepatitis B screening is not performed on all cases where it is indicated (1700/9000 patients). Of those who were screened 16 (0.95%) were positive, which is about twice the prevalence in the general Swiss population (0.53%). Of those who had chronic active hepatitis B, 5 (31.3%) were also hepatitis D co-infected, which is a much higher prevalence than the reported levels in the literature, with a prevalence of 5.9% of hepatitis D in HBsAg-positive patients.

Conclusion
Our patient group has a higher burden of infection and is currently not effectively screened for active hepatitis B and D infection. Routine screening should be the norm.

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