Screening for chronic hepatitis B and C virus infections in an urban sexually transmitted disease clinic: rationale for integrating services.
OBJECTIVE
Clients attending sexually transmitted disease (STD) clinics are at risk for multiple infections (e.g., STDs, HIV, and infectious viral hepatitis). Risk assessment and serosurveys can document the need for hepatitis screening and vaccination services.


OBJECTIVE
To determine hepatitis C and B virus seroprevalence, identify predictive risk factors, and provide a rationale for integrating hepatitis services in an STD clinic.


METHODS
During various periods in 1998, consecutive clients completed a self-administered risk assessment and were offered screening for markers of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection (HBV core antibody and anti-HCV [enzyme-linked immunosorbent assay 3.0, confirmed by recombinant immunoblot assay 2.0]).


RESULTS
Sixteen percent of 300 clients tested for an anti-HBV core were positive, with injecting-drug users (IDUs) and men who have sex with men (MSM) having higher prevalences (50% and 37%, respectively). Of 615 clients tested for anti-HCV, 21 (3.4%) were positive. Injecting-drug users (n = 34) had a 38% anti-HCV prevalence compared with 1.1% for non-IDUs. Of 66 non-IDU MSM tested, none was HCV infected. IDUs had a high prevalence of past STDs (> 50%) and unsafe sexual behavior.


CONCLUSIONS
Injecting drug users and MSM are at high risk for STDs, HIV, and hepatitis infections and could benefit from a "one-stop" STD clinic that included hepatitis prevention services.
Gunn
R A
RA
Centers for Disease Control and Prevention, Health and Human Services Agency, San Diego, California, USA. rgunnxhe@co.san-diego.ca.us
Murray
P J
PJ
Ackers
M L
ML
Hardison
W G
WG
Margolis
H S
HS
D000328:Adult; D000554:Ambulatory Care Facilities; D002140:California / Q000453:epidemiology; D005260:Female; D006297:Health Services Accessibility; D006509:Hepatitis B / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D016036:Seroepidemiologic Studies; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000150:complications*; D019966:Substance-Related Disorders / Q000453:epidemiology; D014504:Urban Health