Risk behaviours and prevalence of blood borne infections in young people seeking treatment or advice for drug use – the potential of dried blood spots.

Author: Øvrehus A, Blunck, H1, Lassen H, Holm D, Søholm J, Skamling M, Christensen PB

Theme: Clinical Research Year: 2019

Engaging people who use drugs in prevention and testing for HIV, Hepatitis B(HBV) and Hepatitis
C(HCV) is important. Besides diagnosing chronic infections, testing can provide an opportunity to
discuss risk behavior and offer advice on prevention. The primary aim was to investigate the
prevalence of HIV, HCV and HBV infection in people aged 18-30 with drug use.
Prospective cohort study. Inclusion criteria: People aged 18-30 in contact with drug treatment
centres. Participants completed a questionnaire including socio-demographics, drug and non-drug
related behaviours and prior testing for HIV/Hepatitis. All participants were offered a finger prick
test (dried blood spot(DBS)). DBS were analysed for HIV-Ab/Ag, HBsAg, HBs-Ab and HCV-Ab and if
positive for viral RNA/DNA. Positive results were confirmed by venous blood test.
From 2017-2018, a total of 180 individuals participated in the survey, 26% were female, median age
23 years, 90% were born in Denmark and 48% were employed or active students and 26 (15%) had
been to prison. Prior testing for HIV/hepatitis was reported by 20%. Selected behaviors reported:
Unprotected sex 94%, transactional sex 21%, use of central stimulants 80%, use of opioids 31%,
injecting drugs 5.7% and sharing snorting straws 90%(of the 85 % snorting drugs). Among 175 DBS
tests, none were HBsAg+ or HIV-Ab/Ag+. Two persons were HCV-RNA+ (Prevalence in cohort 1.1 %,
20% in people reporting injecting). Only 7% had protective antibodies for HBV. At end of follow up
107 (66%) of HBs-Ab neg. individuals had initiated HBV immunization.
Hepatitis C was un-common among young people seeking treatment or counselling for drug use and
confined to people with injecting drug use. Risk factors for infection however were quite prevalent.
Dried blood spots offered an “all in one” solution including the need for HBV immunization as not
part of childhood immunization in Denmark.
Disclosure of Interest Statement
The study was supported by a Gilead Nordic unrestricted research grant.
AØ has received research grants from Gilead and speaker fees and travel support from Gilead,
Abbvie and MSD. JS has received research grants and travel from Abbvie. PBC has received research
grants from Gilead, Abbvie and MSD. HB, HL, MS and DH have nothing to disclose for this paper.

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