title: Evidence of multiple hepatitis virus infections in autopsied materials of intravenous drug addicts.
abstract: Injection of illicit drugs is an important risk factor for acquiring parenterally transmitted viral infections. To investigate the prevalence of viral mono- and co-infections in intravenous drug uses (IDUs) postmortem and to evaluate the risk of potential infection to personnel involved in medicolegal practice a total number of 59 known IDUs were tested during necropsy for serological markers of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) as well as for the nucleic acids of the hepatitis B and C viruses, and the GB virus C (GBV-C), in blood and in the liver. Our findings showed that 90.2% cases were positive for at least one or more serological markers of the tested viruses. Seroprevalence rates of anti-HCV, HBsAg and anti-HIV were 78.4%, 32.4% and 29.7% respectively. Of the IDUs tested for serological infection markers 43.2% were positive for one, 40.5% for two and 5.4% for all three markers. Viral nucleic acids were detected in the sera of 64.4% and in the liver of 81.4% of the cases. HCV, RNA, GBV-C RNA and HBV DNA were found in 33.9%, 28.8% amd 28.8% of the serum samples and in 67.8%, 35.6% and 28.8% of the liver tissue, respectively. Active viral co-infections or triple infections were detectable in the sera of 20.3% and in the liver of 39% of the case. Results show that the sensitivity of viral nucleic acid testing postmortem strongly depends on the quality and source of material used.
authors.affiliation: Children's Hospital, Department I, University of Tuebingen, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Schleicher
authors.forename: Maria
authors.initials: M
authors.lastname: Schieffer
authors.forename: Stefan
authors.initials: S
authors.lastname: Jürgens
authors.forename: Heinz-Dieter
authors.initials: HD
authors.lastname: Wehner
authors.forename: Bertram
authors.initials: B
authors.lastname: Flehmig
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D001344:Autopsy; D004279:DNA, Viral / Q000097:blood / Q000302:isolation & purification; D005260:Female; D018178:Flaviviridae Infections / Q000453:epidemiology* / Q000401:mortality / Q000635:transmission; D029407:GB virus C / Q000235:genetics / Q000276:immunology; D005838:Genotype; D006678:HIV / Q000235:genetics / Q000276:immunology; D015658:HIV Infections / Q000453:epidemiology* / Q000401:mortality / Q000635:transmission; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006509:Hepatitis B / Q000453:epidemiology* / Q000401:mortality / Q000635:transmission; D006510:Hepatitis B Antibodies / Q000032:analysis; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology; D006526:Hepatitis C / Q000453:epidemiology* / Q000401:mortality / Q000635:transmission; D018937:Hepatitis C Antibodies / Q000032:analysis; D006525:Hepatitis, Viral, Human / Q000453:epidemiology* / Q000401:mortality / Q000635:transmission; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood / Q000302:isolation & purification; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016036:Seroepidemiologic Studies; D015819:Substance Abuse, Intravenous / Q000150:complications*
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies; D012367:RNA, Viral