title: HIV and HCV infection among drug users in Japan.
abstract: OBJECTIVE
  To assess seroprevalence of human immunodeficiency virus (HIV), hepatitis C virus, injecting drug use, unsafe sexual behaviours, self-mutilation and tattoos in patients attending a drug and alcohol treatment centre in Japan.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  The work was carried out at the National Sanitarium of Shimousa, Chiba, Japan, a 32-bed inpatient centre specializing in drug and alcohol treatment.
  
  
  METHODS
  Laboratory analyses for HIV antibody, hepatitis C antibody, hepatitis B antigen and antibody; questionnaires for history of sexual activities, needle and syringe use; physical examination with assessment of self-amputated finger joints, tattoos, scars from lacerations and cigarette burns.
  
  
  RESULTS
  No patients tested positive for anti-HIV. The seroprevalence of anti-HCV positives was 53.8% of methamphetamine-dependent patients, 18.4% of solvent-dependent patients and 5.6% of alcohol-dependent patients. Past needle sharing was reported by 82.1% of methamphetamine-dependent patients, 18.4% of solvent-dependent patients and 5.6% of alcohol-dependent patients. A history of syringe sharing was reported by 87.2% of methamphetamine-dependent patients. More than two-thirds of all patients reported contact with commercial sex workers. Casual sexual contacts were more common among solvent and methamphetamine-dependent patients than those dependent on alcohol. Tattoos and cigarette burns were more common among methamphetamine and solvent-dependent patients than among alcohol-dependent patients. Among the methamphetamine-dependent patients, 20.5% reported self-amputated finger joints compared with none in the other patient groups.
  
  
  CONCLUSIONS
  HCV prevalence is a significant problem among methamphetamine users in Japan, probably because of a high rate of needle and/or syringe sharing. Although HIV infection is currently negligible, the very high rate of needle and syringe sharing could give rise to a significant increase in the HIV rate among drug users in the future.
authors.affiliation: National Center of Neurology and Psychiatry, National Institute of Mental Health, Chiba, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Wada
authors.forename: S B
authors.initials: SB
authors.lastname: Greberman
authors.forename: K
authors.initials: K
authors.lastname: Konuma
authors.forename: S
authors.initials: S
authors.lastname: Hirai
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology; D000704:Analysis of Variance; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016485:Needle Sharing; D016728:Self-Injurious Behavior; D012725:Sexual Behavior; D012997:Solvents; D019966:Substance-Related Disorders / Q000453:epidemiology*; D013653:Tattooing
chemical_list: D012997:Solvents