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Screening
for chronic hepatitis B and C virus infections in an urban sexually
transmitted disease clinic: rationale for integrating services.
Sexually Transmitted Diseases 2001;28(3):166-170.
Gunn RA, Murray PJ, Ackers ML, Haridison WGM, Margolis HS.
Abstract
BACKGROUND AND OBJECTIVES: Clients attending sexually transmitted disease
(STD) clinics are at risk for multiple infections (e.g., STDs, HIV, and
infectious viral hepatitis). Risk assessment and serosurveys can document
the need for hepatitis screening and vaccination services. GOAL: To determine
hepatitis C and B virus seroprevalence, identify predictive risk factors,
and provide a rationale for integrating hepatitis services in an STD
clinic. METHODS: During various periods in 1998, consecutive clients
completed a self-administered risk assessment and were offered screening
for markers of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection
(HBV core antibody and anti-HCV [enzyme-linked immunosorbent assay 3.0,
confirmed by recombinant immunoblot assay 2.0]). RESULTS: Sixteen percent
of 300 clients tested for an anti-HBV core were positive, with injecting-drug
users (IDUs) and men who have sex with men (MSM) having higher prevalences
(50% and 37%, respectively). Of 615 clients tested for anti-HCV, 21 (3.4%)
were positive. Injecting-drug users (n = 34) had a 38% anti-HCV prevalence
compared with 1.1% for non-IDUs. Of 66 non-IDU MSM tested, none was HCV
infected. IDUs had a high prevalence of past STDs (> 50%) and unsafe
sexual behavior. CONCLUSIONS: Injecting drug users and MSM are at high
risk for STDs, HIV, and hepatitis infections and could benefit from a "one-stop" STD
clinic that included hepatitis prevention services.