title: Surveillance of HIV and viral hepatitis by analysis of samples from drug related deaths.
abstract: OBJECTIVE
  To determine the prevalence of antibodies against HIV, hepatitis B (HBV) and hepatitis C (HCV) in postmortem samples from drug related deaths (DRDs) in Denmark.
  
  
  METHODS
  Prospective cohort study. Postmortem samples tested for anti-HIV, anti-HCV anti-HBc and anti-HBs. Comparison to pre-mortem testing when possible. DRDs were searched for in the national register of drug treatment, national prison registers, and the national infectious disease register.
  
  
  METHODS
  National level.
  
  
  METHODS
  Drug related deaths admitted to Danish Institutes of Forensic Medicine during 2004.
  
  
  METHODS
  Prevalence of antibodies, injection drug use, drug treatment experience and prevalence of cirrhosis.
  
  
  RESULTS
  Samples for analysis were obtained from 78% (233/299) of DRDs. The prevalences of anti-HIV, anti-HCV and anti-HBc were 4% (9/214), 51% (110/215), and 35% (74/209), indicating a persisting low prevalence of HIV and a declining prevalence of HCV and HBV. Injecting ever was detected among 45% of DRDs and this was associated with a significantly higher prevalence of hepatitis B and C. Among the DRDs 56% received drug treatment and 12% had cirrhosis at autopsy. Evidence of vaccination against HBV was found among 16% (21/128).
  
  
  CONCLUSIONS
  Monitoring of viral hepatitis and HIV among DRDs is feasible, and our survey indicates a falling prevalence among Danish drug users. Surveillance based on drug users in treatment may overestimate the true prevalence.
authors.affiliation: Department of Infectious Diseases, Odense University Hospital, Odense C, DK5000, Denmark. peer.christensen@dadlnet.dk
authors.forename: Peer Brehm
authors.initials: PB
authors.lastname: Christensen
authors.forename: Birgitte
authors.initials: B
authors.lastname: Kringsholm
authors.forename: Jytte
authors.initials: J
authors.lastname: Banner
authors.forename: Jørgen L
authors.initials: JL
authors.lastname: Thomsen
authors.forename: Susan
authors.initials: S
authors.lastname: Cowan
authors.forename: Gabriela Felicia
authors.initials: GF
authors.lastname: Stein
authors.forename: Gitte Wulf
authors.initials: GW
authors.lastname: Jürgensen
authors.forename: Kari
authors.initials: K
authors.lastname: Grasaasen
authors.forename: Jørgen
authors.initials: J
authors.lastname: Georgsen
authors.forename: Court
authors.initials: C
authors.lastname: Pedersen
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001344:Autopsy; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006678:HIV / Q000187:drug effects / Q000502:physiology; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000401:mortality* / Q000821:virology; D016174:Hepacivirus / Q000187:drug effects / Q000502:physiology; D006509:Hepatitis B / Q000150:complications* / Q000188:drug therapy / Q000401:mortality* / Q000821:virology; D006515:Hepatitis B virus / Q000187:drug effects / Q000502:physiology; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy / Q000401:mortality* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D019966:Substance-Related Disorders / Q000150:complications* / Q000401:mortality*
chemical_list: D000998:Antiviral Agents