Abstract
Objectives:
To determine the prevalence of antibodies against HIV, hepatitis B (HBV) and hepatitis C (HCV) in postmortem samples from drug related deaths (DRDs) in Denmark.
Design:
Prospective cohort study. Postmortem samples tested for anti-HIV, anti-HCV anti-HBc and anti-HBs. Comparison to pre-mortem testing when possible. DRDs were searched for in the national register of drug treatment, national prison registers, and the national infectious disease register.
Setting:
National level.
Participants:
Drug related deaths admitted to Danish Institutes of Forensic Medicine during 2004.
Main outcome measures:
Prevalence of antibodies, injection drug use, drug treatment experience and prevalence of cirrhosis.
Results:
Samples for analysis were obtained from 78% (233/299) of DRDs. The prevalences of anti-HIV, anti-HCV and anti-HBc were 4% (9/214), 51% (110/215), and 35% (74/209), indicating a persisting low prevalence of HIV and a declining prevalence of HCV and HBV. Injecting ever was detected among 45% of DRDs and this was associated with a significantly higher prevalence of hepatitis B and C. Among the DRDs 56% received drug treatment and 12% had cirrhosis at autopsy. Evidence of vaccination against HBV was found among 16% (21/128).
Conclusions:
Monitoring of viral hepatitis and HIV among DRDs is feasible, and our survey indicates a falling prevalence among Danish drug users. Surveillance based on drug users in treatment may overestimate the true prevalence.
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Acknowledgements
We thank Eva Hammerby, Sigrid Poulsen, Peter Ege and Else Smith for ideas and comments, Lone Tønning Sørensen and Sussi Mortensen for technical support with postmortem analysis. Financial support was obtained from the Danish National Board of Health and the European Network on Drugs and Infections Prevention in Prison (ENDIPP).
The views expressed in this paper are the responsibility of the authors and not necessarily those of the National Board of Health or ENDIPP.
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Christensen, P.B., Kringsholm, B., Banner, J. et al. Surveillance of HIV and Viral Hepatitis by Analysis of Samples from Drug Related Deaths. Eur J Epidemiol 21, 383–387 (2006). https://doi.org/10.1007/s10654-006-9009-x
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DOI: https://doi.org/10.1007/s10654-006-9009-x