title: Blood-borne hepatitis in opiate users in iran: a poor outlook and urgent need to change nationwide screening policy.
abstract: OBJECTIVE
  Iran has the highest rate of opiate use worldwide. However, most opiate users are not screened for hepatitis virus infections. This study aimed to provide accurate, detailed data on the size of the opiate user population at risk of developing these infections.
  
  
  METHODS
  This seroprevalence study was conducted in the city of Shiraz, southern Iran. All participants were screened for HBV, HCV and HIV infection. The data were analyzed with SPSS.
  
  
  RESULTS
  Among 569 participants, 233 (40.9%) were injection drug users (IDU), 369 (64.8%) were heterosexual, 84 (14.7%) were bisexual and 15 (2.6%) were homosexual. One hundred nine (19.1%) were HCV antibody-positive, 18 (3.1%) were HBS antigen-positive, 72 (12.6%) were HBc antibody-positive and 23 (4%) were HIV-positive. Among IDU compared to non-IDU, positivity rates for HBS antigen (5.5 vs 1.4%), HBc antibody (22.7 vs 5.6%), HCV antibody (40.3 vs 4.4%) and HIV (7.7 vs 1.4%) were higher (P < 0.05). Most patients with HBV (80.7%) and HCV infection (83.4%) were HIV-negative. In the cumulative analysis, only history of imprisonment was a statistically significant determinant of infection by HCV or HBV in opiate users.
  
  
  CONCLUSIONS
  The current policy of screening only HIV-positive drug users for HBV and HCV in Iran misses most cases of HBV and HCV infection. We therefore recommend urgent revision of the nationwide protocol by the Ministry of Health in Iran to implement routine screening of all opiate users and especially IDU for these viruses, regardless of their HIV status.
authors: Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Behnam
authors: B
authors: Honarvar
authors: Neda
authors: N
authors: Odoomi
authors: Mohsen
authors: M
authors: Moghadami
authors: Parvin
authors: P
authors: Afsar Kazerooni
authors: Alireza
authors: A
authors: Hassanabadi
authors: Parvin
authors: P
authors: Zare Dolatabadi
authors: Ehsan
authors: E
authors: Farzanfar
authors: Kamran Bagheri
authors: KB
authors: Lankarani
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006679:HIV Seropositivity; D006505:Hepatitis / Q000453:epidemiology* / Q000209:etiology; D006509:Hepatitis B / Q000453:epidemiology / Q000209:etiology; D006526:Hepatitis C / Q000453:epidemiology; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D016036:Seroepidemiologic Studies; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology*