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Ansprechbarkeit von Drogengebrauchern über Infektionsrisiken für HIV und HCV

Opioidabhängigkeit und HIV-Infektion

Illegal drug users and risk factors for HIV and HCV infection

  • Leitthema: HIV: Prävention und Aufklärung
  • Published:
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Von Beginn der HIV-Epidemie zählten drogenabhängige Menschen zur Hochrisikogruppe insbesondere dann, wenn sie Heroin injizierten. Bereits wenige Jahre nach Entdeckung des Hepatitis-C-Virus (HCV) war klar, dass die chronische Hepatitis C eine der größten Bedrohungen für Heroinabhängige ist. Die HIV-Prävalenz bei Heroinabhängigen beträgt in Deutschland 4–6 %, die HCV-Prävalenz liegt bei über 60 %. 90 % aller HIV-positiven Heroinabhängigen sind gleichzeitig auch HCVpositiv. Die HCV-Inzidenz ist vor allem bei jungen Drogenabhängigen sehr hoch. Präventiv wirksam sind besonders die Substitutionsbehandlung und die Nadelund Spritzenaustauschprogramme. Die Therapie einer HIV-Infektion und einer chronischen Hepatitis C ist während einer Substitutionsbehandlung am effektivsten und erfolgreichsten.

Abstract

Since the beginning of the HIV-epidemic, injection drug users (IDUs) have had a high risk of acquiring an infection with HIV. Chronic hepatitis C (HCV) is the most common infectious disease among IDUs. About 4 to 6 % of IDUs are HIV positive and more than 60 % are HCV positive. 90 % of HIV-positive IDUs are both HIV positive and HCV positive. Substitution treatment is the most effective prevention of HIV and HCV infection. Both HIV infection and chronic hepatitis C can be treated most successfully during substitution treatment.

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Literatur

  1. Krausz M, Verthein U, Degkwitz P (1998) Prävalenz psychiatrischer Komorbidität bei opiatabhängigen Patienten. Nervenarzt 69:557–567

    Article  PubMed  CAS  Google Scholar 

  2. EASL International Consensus Conference on Hepatitis C (1999) Consensus Statement. J Hepatol 30:956–961

    Article  Google Scholar 

  3. Backmund M, Meyer K, von Zielonka M, Eichenlaub D (2001) Treatment of Hepatitis C infection in injection drug users. Hepatology 34:188–193

    Article  PubMed  CAS  Google Scholar 

  4. Backmund M, Meyer K, Henkel C et al. (2005) Risk factors and predictors of human immunodeficiency virus infection among injection drug users. Eur Addict Res 11:138–144

    Article  PubMed  Google Scholar 

  5. UNAIDS (Joint United Nations Programme on HIV/ AIDS) (2006) 2006 Report on the Global AIDS Epidemic: A UNAIDS 10th anniversary special edition. UNAIDS, Geneva, Switzerland

    Google Scholar 

  6. Dehne KL, Khodakevich L et al. (1999) "The HIV/ AIDS epidemic in eastern Europe: recent patterns and trends and their implications for policymaking." AIDS 13(7):741–749

    Article  PubMed  CAS  Google Scholar 

  7. National Institutes of Health Consensus Development Conference Panel Statement (1997) Management of Hepatitis C. Hepatology 26(Suppl): 71S–77S

    Article  Google Scholar 

  8. Backmund M, Meyer K, Wächtler M, Eichenlaub D (2003) Hepatitis C virus infection in injection drug users in Bavaria: risk factors for seropositivity. Eur J Epidemiol 18:563–568

    Article  PubMed  Google Scholar 

  9. Backmund M, Meyer K, von Zielonka (2001) Prävalenzdaten zu B und C bei Drogenabhängigen in München. Suchtmed 3:21–24

    Google Scholar 

  10. Sylvestre DL, Lottis J, Hauser P et al (2004) Cooccurring hepatitis C, substance use, and psychiatric illness: treatment issues and developing integrated models of care. J Urban Health 81:719–734

    PubMed  Google Scholar 

  11. Schäfer M, Schmidt F, Folwacnzy C et al. (2003) Adherence and mental side effects during hepatitis C treatment with inteferon alfa and ribavirin in psychiatric risk groups. Hepatology 37:443–451

    Article  CAS  Google Scholar 

  12. Hüllinghorst R (1993) Zur Versorgung Suchtkranker in Deutschland. In: Deutsche Hauptstelle gegen die Suchtgefahren (Hrsg) Jahrbuch Sucht 94. Neulandverlag, Geesthacht, S 23–37

  13. Kraus L, Heppekausen K, Tretter F (2004) Prävalenzschätzungen von Opiatkonsumenten in deutschen Großstädten: Methoden und Ergebnisse. Sucht 50:11–20

    Google Scholar 

  14. Aceijas C, Stimson GV, Hickman M et al. (2004) Prevention and care among IDU in developing and transitional countries. AIDS 18:2295–2303

    Article  PubMed  Google Scholar 

  15. Robert Koch Institut (2006) Epidemiol Bull 47: 411–426

    Google Scholar 

  16. Wiessing L, Roy K, Sapinho D et al. (2004) Surveillance of hepatitis C infection among injecting drug users in the European Union. In: Jager J, Kretschmar, M, Potsma M, Wiessing L (eds) Hepatitis C and injecting drug use: impact, costs and policy Z options. EMCDDA Monographs 7:91–135

    Google Scholar 

  17. Reimer J, Schulte B, Castells X et al. (2005) Guidelines for treatment of hepatitis C virus infection in injecting drug users: status quo in the European Union Countries. Clin Infect Dis 40(Suppl 5):S373–S378

    Article  PubMed  Google Scholar 

  18. Conry-Cantilena C, VanRaden M, Gibble J et al. (1996) Routes of infection, viremia, and liver disease in blood donors found to have hepatitis C virus infection. N Engl J Med 334:1691–1696

    Article  PubMed  CAS  Google Scholar 

  19. Chiaramonte M, Stroffolini T, Lorenzoni U et al. (1996) Risk factors in community-acquired chronic hepatitis C virus infection: a case-control study in Italy. J Hepatol 24:129–134

    Article  PubMed  CAS  Google Scholar 

  20. Garfein RS, Doherty MC, Monterroso ER et al. (1998) Prevalence and incidence of hepatitis C virus infection among young adult injecting drug users. J Acquir Immune Defic Syndr Hum Retrovirol 18(Suppl 1):11S–19S

    Google Scholar 

  21. Nalpas B, Desenclos JC, Delarocque-Astagneau E, Drucker J (1998) State of epidemiological knowledge and national management of hepatitis C virus infection in the European Community, 1996. Eur J Public Health 8:305–312

    Article  Google Scholar 

  22. Backmund M, Reimer J, Meyer K et al. (2005) Hepatitis C and substance abuse: Treatment of IDUs. Clin Infect Dis 40(Suppl 5):S330–S335

    Article  PubMed  Google Scholar 

  23. Backmund M, Hinrichsen H, Reimer J et al. (2006) Leitlinien der Deutschen Gesellschaft für Suchtmedizin (DGS e.V.): Therapie der chronischen Hepatitis C bei intravenös Drogengebrauchern. Suchtmed 8:131–133

    Google Scholar 

  24. Van Ameijden EJC, van den Hoek JAR, Mientjes GHC, Coutinho RA (1993) A longitudinal study of the incidence and transmission patterns of HIV, HBV and HCV infection among drug users in Amsterdam. Eur J Epidemiol 9:255–262

    Article  PubMed  CAS  Google Scholar 

  25. Levine OS, Vlahov D, Brookmeyer R et al. (1996) Differences in the incidence of hepatitis B and human immunodeficiency virus infections among injecting drug users. J Infect Dis 173:579–583

    PubMed  CAS  Google Scholar 

  26. Van Beek I, Dwyer R, Dore GJ et al. (1998) Infection with HIV and hepatitis C virus among injecting drug users in a prevention setting: a retrospective cohort study. BMJ 317:433–437

    PubMed  CAS  Google Scholar 

  27. Brogly SB, Bruneau J, Vinclette J et al. (2000) Risk behaviour change and HIV infection among injection drug users in Montreal. AIDS 14:2575–2582

    Article  PubMed  CAS  Google Scholar 

  28. Platt L, Bobraca N, Rhodes T et al. (2006) High HIV prevalence among injecting drug uses in Estonia: implications for understanding the risk environment. AIDS 20:2120–2123

    Article  PubMed  Google Scholar 

  29. Offergeld R, Stark K, Hamouda O (2003) Transfusion relevant diseases in blood donors. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 46:775–779

    Article  Google Scholar 

  30. Dore GJ, Law M, MacDonald M, Kaldor JM (2003) Epidemiology of hepatitis C virus infection in Australia. J Clin Virol 26:171–184

    Article  PubMed  Google Scholar 

  31. Vlahov D, Junge B (1998) The role of needle exchange programs in HIV prevention. Public Health Rep 113(Suppl 1):75–80

    PubMed  Google Scholar 

  32. Friedman SR, Jose B, Deren S et al. (1995) Risk factors for human immunodeficiency virus seroconversion among out-of-treatment drug injectors in high and low seroprevalence cities. The National AIDS Research Consortium. Am J Epidemiol 142:864–874

    PubMed  CAS  Google Scholar 

  33. Johnson RA, Gerstein DR, Cerbone FG, Brown J (2002) HIV risk behaviors in African-American drug injector networks: implications of injection-partner mixing and partnership characteristics. Addiction 97:1011–1024

    Article  PubMed  Google Scholar 

  34. Guadagnino V, Zimatore G, Izzi A et al. (1995) Relevance of intravenous cocaine use in relation to prevalence of HIV, hepatitis B and C virus markers among intravenous drug abusers in southern Italy. J Clin Lab Immunol 47:1–9

    PubMed  CAS  Google Scholar 

  35. Bensley LS, Van Eenwyk J et al. (2000) Selfreported childhood sexual and physical abuse and adult HIV-risk behaviors and heavy drinking. Am J Prev Med 18(2):151–158

    Article  PubMed  CAS  Google Scholar 

  36. Burke JG, Thiemann LK et al. (2005) Intimate partner violence, substance use, and HIV among lowincome women: taking a closer look. Violence Against Women 11(9):1140–1161

    Article  PubMed  Google Scholar 

  37. Cohen M, Deamant C et al. (2000) Domestic violence and childhood sexual abuse in HIV-infected women and women at risk for HIV. Am J Public Health 90(4):560–565

    PubMed  CAS  Google Scholar 

  38. Miller CL, Wood E et al. (2004) The future face of coinfection: prevalence and incidence of HIV and hepatitis C virus coinfection among young injection drug users. J Acquir Immune Defic Syndr 36(2):743–749

    Article  PubMed  Google Scholar 

  39. Miller M (1999) A model to explain the relationship between sexual abuse and HIV risk among women. AIDS Care 11(1):3–20

    Article  PubMed  CAS  Google Scholar 

  40. El-Bassel N, Gilbert L et al. (2004) Deconstructing the relationship between intimate partner violence and sexual HIV risk among drug-involved men and their female partners. AIDS Behav 8(4):429–439

    Article  PubMed  Google Scholar 

  41. Strathdee SA, Patrick DM et al. (1997) Social determinants predict needle-sharing behavior among injection drug users in Vancouver, Canada. Addiction 92(10):1339–1347

    Article  PubMed  CAS  Google Scholar 

  42. Dube SR, Felitti VJ, Dong M et al. (2003) Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: the adverse childhood experiences study. Pediatrics 111:564–572

    Article  PubMed  Google Scholar 

  43. Hagan H, Mc Gough JP, Thiede H et al. (1999) Syringe exchange and risk of infection with hepatitis B and C viruses. Am J Epidemiol 149:203–213

    Google Scholar 

  44. Mansson AS, Moestrup T, Nordenfelt E, Widell A (2000) Continued transmission of hepatitis B and C viruses, but no transmission of human immunodeficiency virus among intravenous drug users participating in a syringe/needle exchange program. Scand J Infect Dis 32(3):253–258

    Article  PubMed  CAS  Google Scholar 

  45. Haltmayer H, Schmidt R, Strobel S (2000) Qualitätscheck – Untersuchungen über den i.v. Konsum illegaler Drogen mittels Analyse von gebrauchten Injektionsspritzen. Suchtmed 2(Suppl 1):285

    Google Scholar 

  46. Hagan H, Thiede H, Weiss NS et al. (2001) Sharing of drug preparation equipment as a risk factor for hepatitis C. Am J Public Health 91:42–46

    Article  PubMed  CAS  Google Scholar 

  47. Hahn JA, Page-Shafer K, Lum PJ et al. (2002) Hepatitis C virus seroconversion among young injection drug users: relationships and risks. J Infect Dis 186:1558–1564

    Article  PubMed  Google Scholar 

  48. Gowing LR, Farrell M, Bornemann R, Ali R (2004) Substitution treatment of injecting opioid users for prevention of HIV infection. The Cochrane Database of Systematic Reviews 4:CDoo4145

    Google Scholar 

  49. Gowing LR, Farrell M, Borneman R et al. (2005) Brief report: Methadone treatment of injecting opioid users for prevention of HIV infection. J Gen Intern Med 20:1–3

    Article  Google Scholar 

  50. Backmund M, Meyer K (2006) Hepatitis-C-Therapie während der Substitutionsbehandlung. Suchtmed 8:115–118

    Google Scholar 

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Backmund, M. Ansprechbarkeit von Drogengebrauchern über Infektionsrisiken für HIV und HCV. Bundesgesundheitsbl. 50, 471–475 (2007). https://doi.org/10.1007/s00103-007-0189-7

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