Prevalence of hepatitis B and C infection in a methadone clinic population: implications for hepatitis B vaccination.
OBJECTIVE
To examine the HBV and HCV markers of injecting drug users on methadone maintenance, and the feasibility of vaccination at the drug clinic.


METHODS
Systematic serological testing of patients for hepatitis B and C was undertaken, and free hepatitis B vaccination was offered via arranged clinic appointments.


RESULTS
Hepatitis B serology was obtained in 163 of the 220 clinic patients. 85 (52.1%) patients had evidence of hepatitis B exposure, and 3 (1.8%), of previous vaccination. Positive hepatitis B markers were associated with increasing age (p=0.004), and the duration of injecting prior to treatment (p=0.008). Hepatitis B and C serology was obtained for 153 patients, with 76 (49.7%) having evidence of dual exposure. 164 (84.1%) of 195 patients were positive for antibody to hepatitis C. Completion of the vaccine course was lower than anticipated (36.5% of HBV negative patients).


CONCLUSIONS
The high rates of hepatitis B exposure in injecting drug users on methadone treatment confirm the need for hepatitis B vaccination, particularly in view of their endemic hepatitis C infection. Monitoring of this group for the development of chronic liver disease and hepatocellular carcinoma is recommended. Routine cost-free vaccination of patients on entering drug treatment, using a rapid vaccination schedule, may improve compliance.
Carter
H
H
Wellington Opioid Substitution Clinic, Capital Coast Health.
Robinson
G
G
Hanlon
C
C
Hailwood
C
C
Massarotto
A
A
D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005240:Feasibility Studies; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000517:prevention & control; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006526:Hepatitis C / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D009293:Opioid-Related Disorders / Q000150:complications / Q000453:epidemiology* / Q000534:rehabilitation; D016320:Substance Abuse Treatment Centers; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology* / Q000534:rehabilitation
D017325:Hepatitis B Vaccines; D008691:Methadone