Six human hepatitis viruses (designated A, B, C, D, E and G) have been identified and characterised. The D virus accounts for only approximately 2% of cases of viral hepatitis, whilst the E virus is very rare. Injecting drug users are at high risk of infection with hepatitis viruses. In one study of 389 intravenous addicts in California, 41% had antibodies to HAV, 73% to HBV, 94% to HCV and 10% to HDV (Tenant & Moll, 1995). In another study of 716 injecting drug users in Baltimore, 66% had antibodies to
HBV and 77% to HCV (Garfein & Vlahov et al, 1996). In the UK, recent evidence suggests that between 50 and 80% of past and current injecting drug users may be infected with hepatitis C (Di Bisceglie A, 1998).
The majority of drug using clients who are tested as antibody positive for a hepatitis virus will be currently asymptomatic. Baseline advice for all such clients should be to avoid the use of alcohol, and care should be taken that medications associated with chronic hepatitis and cirrhosis are prescribed only with extreme caution (e.g. aspirin, chlorpromazine, sulphonamides).
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The above information is copyright of Dr Bruce Trathen MBBS MRCPsych (2006). ISBN 0-9545164-0-0. The author grants permission for these guidelines to be downloaded, copied and distributed freely, but does not grant permission for their sale.
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