heroin and Hepatitis--Viral--Human

Medical complications of heroin overdose and the diseases of addicts play an increasingly important role in the daily routine of hospital medical departments. The percentage of drug-related admissions to the Medical Clinic of the University Hospital, Zürich, increased from 0.18% to 4.45% between 1972 and 1983. During this 12-year period, 492 patients were admitted 569 times because of heroin overdose or intoxications combined with other drugs, and 191 drug addicts were hospitalized 226 times for a variety of medical problems. Certain complications, such as heroin pulmonary edema and talc granulomas of the lung, occur only in parenteral drug addiction. Other diseases such as right heart endocarditis, Candida-endophthalmitis, septic arthritis and osteomyelitis are almost exclusively observed in intravenous drug abusers. Sexually transmitted infections and hepatitis B are frequently diagnosed in addicts.

Topics: Adolescent; Adult; Age Factors; Arthritis, Infectious; Candidiasis; Cardiovascular Diseases; Endocarditis, Bacterial; Female; Hepatitis, Viral, Human; Heroin; Heroin Dependence; Humans; Length of Stay; Lung Diseases; Male; Nervous System Diseases; Osteomyelitis; Pulmonary Edema; Rhabdomyolysis; Sex Factors; Sexually Transmitted Diseases; Skin Diseases; Switzerland

Sera from 172 intravenous drug users were tested for the presence of antibodies to hepatitis C virus (anti-HCV). The results were analysed in relation to aspects of the history of drug use and evidence of liver disease. The presence of anti-HCV was strongly associated with duration of intravenous drug use. Two-thirds of patients were anti-HCV seropositive within two years of commencing regular intravenous drug use, and there was 100% seropositivity among people injecting drugs for more than eight years. Seropositivity for hepatitis C virus closely paralleled exposure to hepatitis B virus, which was also endemic in this population. In contrast, only one patient tested positive for antibodies to the human immunodeficiency virus. The presence of anti-HCV correlated poorly with biochemical markers of hepatitis. About half the patients with anti-HCV had normal serum levels of alanine aminotransferase, whereas an abnormal liver biochemistry was frequently observed in anti-HCV seronegative subjects. Previous studies of non-A, non-B hepatitis that have used abnormal liver biochemistry as a marker have underestimated the prevalence of chronic hepatitis among intravenous drug users; the use of a specific screening test reveals that infection with hepatitis C virus is very common in this population.

Topics: Adult; Alanine Transaminase; Female; Hepatitis Antibodies; Hepatitis B virus; Hepatitis C; Hepatitis, Viral, Human; Heroin; Humans; Male; New South Wales; Prevalence; Prisoners; Substance Abuse, Intravenous; Time Factors

The prevalence, risk factors, and incidence of hepatitis C virus (HCV) infection were studied in a cohort of drug users in Amsterdam. In intravenous drug users, the seroprevalence was 74% (224/304) versus 10% (4/42) in nonintravenous drug users. Risk factors independently associated with HCV antibody seropositivity were history and duration of intravenous drug use and frequency of injections. Daily smoking of heroin in the previous 6 months was independently associated with the absence of HCV antibodies. Periods of fever, tiredness, and diarrhea in the preceding 6 months were associated with HCV antibodies even after correction for human immunodeficiency virus infection. The incidence rate of HCV infection appeared high and stable over the years 1986 to 1989. Thus, HCV infections are common among intravenous drug users and are mainly due to the intravenous use of drugs.

Topics: Adult; Analysis of Variance; Cohort Studies; Female; Follow-Up Studies; Hepatitis Antibodies; Hepatitis C; Hepatitis, Viral, Human; Heroin; Homosexuality; Humans; Incidence; Longitudinal Studies; Male; Multivariate Analysis; Netherlands; Prevalence; Regression Analysis; Risk Factors; Sex Work; Sexually Transmitted Diseases; Substance Abuse, Intravenous; Substance-Related Disorders

Fifty drug addicts with parenteral heroin abuse and tentative diagnosis of acute hepatitis were examined by means of biochemical and serological tests and by liver biopsy. Diagnosis of acute hepatitis was confirmed in 23 patients. 12 patients were examined by liver biopsy a second time 2 months to 18 months later, 3 patients underwent liver biopsy three times. In 80% of the patients markers of hepatitis B (HBsAg, anti-HBs and anti-HBc) were found in the sera. There is some evidence of not only hepatitis B, but also hepatitis non-A, non-B in parenteral drug addicts leading to protracted forms of acute hepatitis and chronic hepatitis.

Topics: Adolescent; Adult; Female; Hepatitis B; Hepatitis C; Hepatitis, Viral, Human; Heroin; Humans; Injections, Intravenous; Liver; Male; Narcotics; Substance-Related Disorders

Topics: Adult; Autoantibodies; Bacterial Infections; Biopsy; Chemical and Drug Induced Liver Injury; Cholestasis, Extrahepatic; Cholestasis, Intrahepatic; Diagnosis, Differential; Female; Halothane; Hepatitis; Hepatitis B Antibodies; Hepatitis B Surface Antigens; Hepatitis, Viral, Human; Heroin; Heroin Dependence; Humans; Hypergammaglobulinemia; Liver; Liver Diseases; Liver Function Tests; Male; Middle Aged

Topics: Adolescent; Adult; Brain Edema; Female; Hepatitis, Viral, Human; Heroin; Heroin Dependence; Humans; Male; Pulmonary Edema; Pulmonary Embolism

Hepatitis B surface antigen (HBsAg) of subtype ay predominates among narcotic addicts infected with hepatitis B virus (HBV) in Europe, Australia and the United States. However, the ad subtype predominates among the non-addict carriers of HBsAg. We investigated the possibility that heroin lots were contaminated with HBV at a source of opium production, the Middle East, a geographical region where HBsAg/ay predominates in the general population. One hundred and nine lots of street heroin were assayed for HBsAg by radioimmunoassay. None of the lots tested was reproduceably HBsAg positive. These results suggest that the heroin itself is not responsible for the high incidence of HBV infection or for the predominance of HBsAg/ay in the addict population. The predominance of HBsAg/ay among addicts in Europe and Australia as well as the United States might be due to extensive needle sharing among a mobile population of drug abusers, although such worldwide dissemination of one subtype by these means is unlikely.

Topics: Hepatitis B Surface Antigens; Hepatitis B virus; Hepatitis, Viral, Human; Heroin; Heroin Dependence; Humans; Illicit Drugs; Pharmaceutical Preparations; Turkey; United States

Topics: Hepatitis B; Hepatitis, Viral, Human; Heroin; Heroin Dependence; Jaundice; Substance-Related Disorders

Topics: Hepatitis B; Hepatitis, Viral, Human; Heroin; Heroin Dependence; Humans; Jaundice; Medical Records; Substance-Related Disorders

Topics: Hepatitis; Hepatitis A; Hepatitis, Viral, Human; Heroin; Humans