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.
Literatur
Krausz M, Verthein U, Degkwitz P (1998) Prävalenz psychiatrischer Komorbidität bei opiatabhängigen Patienten. Nervenarzt 69:557–567
EASL International Consensus Conference on Hepatitis C (1999) Consensus Statement. J Hepatol 30:956–961
Backmund M, Meyer K, von Zielonka M, Eichenlaub D (2001) Treatment of Hepatitis C infection in injection drug users. Hepatology 34:188–193
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
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
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
National Institutes of Health Consensus Development Conference Panel Statement (1997) Management of Hepatitis C. Hepatology 26(Suppl): 71S–77S
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
Backmund M, Meyer K, von Zielonka (2001) Prävalenzdaten zu B und C bei Drogenabhängigen in München. Suchtmed 3:21–24
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
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
Hüllinghorst R (1993) Zur Versorgung Suchtkranker in Deutschland. In: Deutsche Hauptstelle gegen die Suchtgefahren (Hrsg) Jahrbuch Sucht 94. Neulandverlag, Geesthacht, S 23–37
Kraus L, Heppekausen K, Tretter F (2004) Prävalenzschätzungen von Opiatkonsumenten in deutschen Großstädten: Methoden und Ergebnisse. Sucht 50:11–20
Aceijas C, Stimson GV, Hickman M et al. (2004) Prevention and care among IDU in developing and transitional countries. AIDS 18:2295–2303
Robert Koch Institut (2006) Epidemiol Bull 47: 411–426
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
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
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
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
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
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
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
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
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
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
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
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
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
Offergeld R, Stark K, Hamouda O (2003) Transfusion relevant diseases in blood donors. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 46:775–779
Dore GJ, Law M, MacDonald M, Kaldor JM (2003) Epidemiology of hepatitis C virus infection in Australia. J Clin Virol 26:171–184
Vlahov D, Junge B (1998) The role of needle exchange programs in HIV prevention. Public Health Rep 113(Suppl 1):75–80
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
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
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
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
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
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
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
Miller M (1999) A model to explain the relationship between sexual abuse and HIV risk among women. AIDS Care 11(1):3–20
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
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
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
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
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
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
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
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
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
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
Backmund M, Meyer K (2006) Hepatitis-C-Therapie während der Substitutionsbehandlung. Suchtmed 8:115–118
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
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
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00103-007-0189-7