title: HIV, hepatitis C virus, and hepatitis B virus co-infections among injecting drug users in Tehran, Iran.
abstract: OBJECTIVE
  To assess the prevalence of HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) infections and co-infections among injecting drug users (IDUs) in Tehran.
  
  
  METHODS
  A sample of 899 IDUs (861 male and 38 female) was recruited in Tehran from treatment and harm reduction facilities and from drug user hangouts in public areas in equal proportions. ELISA testing for HIV, HCV antibody (HCV-Ab), hepatitis B surface antigen (HBsAg), and hepatitis B core antibody (HBcAb) was carried out. Positive HIV tests were rechecked by Western blot.
  
  
  RESULTS
  The prevalence of HIV was 10.7%, HCV infection was 34.5%, and past or current HBV infection was 50.7%. Infection with all three viruses was seen in 6.5% (95% confidence interval 4.9-8.2) of participants. HIV/HCV, HIV/HBV, and HBV/HCV co-infections were seen in 8.7%, 7.8%, and 21.0% of participants, respectively. The rate of HCV infection among HIV-positive cases was significantly higher than in HIV-negative IDUs (80.6% vs. 28.7%, p<0.0001). There was no significant association between these infections and co-infections with gender and source of sampling.
  
  
  CONCLUSIONS
  In general, co-infection with these three blood-borne viruses is common among IDUs. Since co-infection increases the morbidity and mortality of all infections, the observed level of co-infection in the high number of IDUs in Iran necessitates a serious comprehensive response.
authors.affiliation: Iranian Research Center for HIV/AIDS (IRCHA), Tehran University of Medical Sciences, Imam Khomeini Hospital, Keshavarz Blvd., Tehran, Iran.
authors.forename: Afarin
authors.initials: A
authors.lastname: Rahimi-Movaghar
authors.forename: Emran M
authors.initials: EM
authors.lastname: Razaghi
authors.forename: Elaheh
authors.initials: E
authors.lastname: Sahimi-Izadian
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Amin-Esmaeili
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000453:epidemiology*; D006508:Hepatitis Antibodies / Q000097:blood / Q000276:immunology; D006509:Hepatitis B / Q000453:epidemiology*; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D006526:Hepatitis C / Q000453:epidemiology*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016036:Seroepidemiologic Studies; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D014505:Urban Population
chemical_list: D015483:HIV Antibodies; D006508:Hepatitis Antibodies; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies