Hepatitis C, B, and human immunodeficiency virus infections in illicit drug users in Israel: prevalence and risk factors.
BACKGROUND
Infections with blood-borne viruses are a major health problem among illicit drug users. There is little information about infection rates and risk factors for hepatitis virus B, C or the human immunodeficiency virus in drug users in Israel.


OBJECTIVE
To determine the prevalence of HCV, HBV and HIV infections in a large cohort of drug users in Israel; to compare rates of HCV, HBV and HIV between injecting versus non-injecting drug users and between different countries of origin; and to identify risk factors for HCV among illicit drug users.


METHODS
We conducted a cross-sectional study using an interviewer-administered questionnaire and serological screening for HCV, HBV and HIV in 1443 consecutive drug users diagnosed at the Israeli National Center for Diagnosis of Drug Addicts between January 2003 and December 2005.


RESULTS
Fourteen (0.9%), 51 (3.5%) and 515 (35.7%) subjects tested positive for HIV, HBV and HCV, respectively. All three infections (HIV, HBV and HCV) were significantly more common among injecting drug users and immigrants from the former Soviet Union and other East European countries compared to native Israelis. Multivariate analysis showed that HCV infection was associated with age (> 40 years) (OR=2.06, 95% CI 1.40-3.03), immigration from East European countries and the former Soviet Union (OR=4.54, 95% CI 3.28-6.28), and injecting drug use (OR=16.44, 95% CI 10.79-25.05).


CONCLUSIONS
HIV, HBV and HCV prevalence among drug users in Israel is significantly lower than in North America and West Europe. Risk factors for HCV infection in this population include injecting drug use, older age, and immigration from the former Soviet Union.
Loebstein
Ronen
R
Institute of Clinical Pharmacology and Toxicology, Sheba Medical Center, Tel Hashomer, Israel. ronen.loebstein@sheba.health.gov.il
Mahagna
Rafae
R
Maor
Yasmin
Y
Kurnik
Daniel
D
Elbaz
Eliyahu
E
Halkin
Hillel
H
Olchovsky
David
D
Ezra
David
D
Almog
Shlomo
S
D000328:Adult; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006509:Hepatitis B / Q000453:epidemiology*; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology*; D055815:Young Adult