title: Rates of HIV and Hepatitis Infections in Clients Entering Heroin-Assisted Treatment between 2003 and 2013 and Risk Factors for Hepatitis C Infection.
abstract: OBJECTIVE
  We report on the rates of hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) in 1,313 clients entering heroin-assisted treatment (HAT) in Switzerland from 2003 to 2013. We identify predictors of HCV infection.
  
  
  METHODS
  Data were collected using questionnaires within 2 weeks of clients' first entry into HAT. Prevalence of HAV, HBV, HCV and HIV was calculated using laboratory test results collected at entry or using reports of older test results. Predictors of HCV status were identified through multiple logistic regression analysis.
  
  
  RESULTS
  Results show stable rates of HIV-positive clients and decreasing proportions of HAV- and HBV-infected clients. In 2013, there were 12% (n = 8) HIV-, 20% (n = 12) HAV-, 20% (n = 12) HBV- and 52% HCV- (n = 34) positive clients. Vaccination against HAV and HBV had become more frequent. Predictors of positive HCV status included older age, female gender, earlier year of entry, having spent 1 month or more in detention or prison, use of injected heroin and more years of intravenous use.
  
  
  CONCLUSIONS
  Our results highlight the fact that efforts to prevent and test for infections and to promote vaccination against HAV and HBV in heroin users need to be continued.
authors.affiliation: Swiss Research Institute for Public Health and Addiction ISGF, Konradstrasse, Postfach, Zx00FC;rich, Switzerland.
authors.forename: Maria
authors.initials: M
authors.lastname: Dickson-Spillmann
authors.forename: Severin
authors.initials: S
authors.lastname: Haug
authors.forename: Ambros
authors.initials: A
authors.lastname: Uchtenhagen
authors.forename: Philip
authors.initials: P
authors.lastname: Bruggmann
authors.forename: Michael P
authors.initials: MP
authors.lastname: Schaub
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006506:Hepatitis A / Q000453:epidemiology*; D006509:Hepatitis B / Q000453:epidemiology*; D006526:Hepatitis C / Q000453:epidemiology*; D006556:Heroin Dependence / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000628:therapy*; D013557:Switzerland