Risks for HIV, HBV, and HCV infections among male injection drug users in northern Vietnam: a case-control study

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Risks for HIV, HBV, and HCV infections among male injection drug users in

northern Vietnam: a case-control study

Authors: Vu Minh Quan a; Vivian F. Go a; Le Van Nam b; Bergenstrom a;

Nguyen Phuong Thuoc b; Zenilman c; Carl Latkin a; D. Celentano

a

Affiliations: a s Hopkins University Bloomberg School of Public Health,

Baltimore, MD, USA

b Bac Ninh Department of Health, Bac Ninh, Vietnam

c s Hopkins University School of Medicine, Baltimore, MD, USA

DOI: 10.1080/09540120802017610

Publication Frequency: 12 issues per year

Published in: AIDS Care, Volume 21, Issue 1 January 2009 , pages 7 - 16

Abstract

Injection drug use (IDU) and HIV infection are important public health problems

in Vietnam. The IDU population increased 70% from 2000 to 2004 and is

disproportionately affected by HIV and AIDS - the country's second leading cause

of death. Hepatitis B virus (HBV) and hepatitis C virus (HCV) share transmission

routes with HIV and cause serious medical consequences. This study aimed to

determine risk factors for acquisition of HIV, HBV, and HCV infections among

IDUs in a northern province. We conducted a matched case-control study among

active IDUs aged 18-45 who participated in a community-based survey (30-minute

interview and serologic testing). Each HIV-infected IDU (case) was matched with

one HIV-uninfected IDU (control) by age, sex (males only), and study site (128

pairs). Similar procedures were used for HBV infection (50 pairs) and HCV

infection (65 pairs). Conditional logistic regression models were fit to

identify risk factors for each infection. Among 309 surveyed IDUs, the HIV, HBV,

and HCV prevalence was 42.4%, 80.9%, and 74.1%, respectively. Only 11.0%

reported having been vaccinated against hepatitis B. While 13.3% of the IDUs

reported sharing needles (past six months), 63.8% engaged in indirect sharing

practices (past six months), including sharing drug solutions, containers, rinse

water, and frontloading drugs. In multivariable models, sharing drugs through

frontloading was significantly associated with HIV infection (odds ratio

[OR]=2.8), HBV infection (OR=3.8), and HCV infection (OR=4.6). We report an

unrecognized association between sharing drugs through frontloading and higher

rates of HIV, HBV and HCV infections among male IDUs in Vietnam. This finding

may have important implications for bloodborne viral prevention for IDUs in

Vietnam.