Surveillance of HIV and viral hepatitis by analysis of samples from drug related deaths.
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.
Christensen
Peer Brehm
PB
Department of Infectious Diseases, Odense University Hospital, Odense C, DK5000, Denmark. peer.christensen@dadlnet.dk
Kringsholm
Birgitte
B
Banner
Jytte
J
Thomsen
Jørgen L
JL
Cowan
Susan
S
Stein
Gabriela Felicia
GF
Jürgensen
Gitte Wulf
GW
Grasaasen
Kari
K
Georgsen
Jørgen
J
Pedersen
Court
C
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*
D000998:Antiviral Agents