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SEROPREVALENCE OF HBsAg, Anti-HBs, Anti-HCV, and Anti-HIV IN PATIENTS WITH ALCOHOL AND SUBSTANCE ABUSE IN AN AMATEM CLINIC IN EASTERN TURKIYE: A SIX-YEAR RETROSPECTIVE EVALUATION

Yıl 2022, Cilt 12, Sayı 6, 959 - 965, 30.11.2022
https://doi.org/10.16899/jcm.1189072

Öz

Aim Substance abuse and concomitant infections are important causes of morbidity and mortality. Yet, the number of epidemiological studies regarding infectious diseases in people with substance abuse are limited in our country. In this study, the aim was to investigate the frequency of illegal alcohol and substance use in an Alcohol and Drug Research, Treatment and Training Centres (AMATEM) clinic in Turkey as well as the HBsAg, anti-HBs, anti-HCV, and anti-HIV parameters between the years of 2016-2021. Material and Method HBsAg, anti-HBs, anti-HCV, and anti-HIV tests were conducted using the ELISA technique in 6881 alcohol and substance use disorder (ASUD). Urine samples from ASUD’s were analyzed for alcohol, cannabis, and cocaine metabolites. The results were evaluated retrospectively. Results All of the 6881 ASUD’s were male with a mean age of 32.18±9.66 years. Of the 6881 ASUD’s included in the study, 4107 (59.7%) were opioid addicts; 1479 (21.5%) were mixed drug addicts; 897 (13%) were alcohol addicts; and the rest were addicts with other types of substance use. The mean age of the alcohol users was 45.33±13.03 and the mean age of opioid users was 29.90±7.13. The percentage of opioid addiction in 2016 was 71.2% which dropped to 28.7% in 2021. Meanwhile, the percentage of alcohol addiction was 13.6% in 2016 and increased to 21.4% in 2021; and the percentage of mixed drug use was 8.7% in 2016 and increased to 36.8% in 2021. HBsAg-positivity in opioid users (56.7%) was higher compared to cannabis users (2.6%) and mixed drug users (22.3%). Anti-HCV positivity of opioid users (69.4%) was found to be higher compared to alcohol (9.4%), cannabis (2%), and mixed drug (16.2%) users, and this finding was statistically significant (p=0.0001). Anti-HBs positivity of opioid users (63.1%) was found to be higher compared to alcohol (9.9%), cannabis (3%), and mixed drug (21%) users, and this finding was statistically significant (p=0.0001). Anti-HIV was determined negative in all ASUD’s. The highest rates of HBsAg, anti-HCV and anti-HBs positivity were found in the 26-30 years of age. Conclusion These findings indicate a high prevalence of intravenous substance abuse in the 26-30 years age group in our region as well as the high HBV and HCV rates in this patient group.

Kaynakça

  • 1.Herrmann ES, Matusiewicz AK, Stitzer ML, Higgins ST, Sigmon SC, Heil SH. Contingency Management Interventions for HIV, Tuberculosis, and Hepatitis Control Among Individuals With Substance Use Disorders: A Systematized Review. J Subst Abuse Treat 2017;72:117-125.
  • 2. Scheibe A, Young K, Versfeld A, et al. Hepatitis B, hepatitis C and HIV prevalence and related sexual and substance use risk practices among key populations who access HIV prevention, treatment and related services in South Africa: findings from a seven-city cross-sectional survey (2017). BMC Infectious Diseases 2020;20(1):655.
  • 3. World Health Organization. Consolidated guidelines on HIV prevention, diagnosis, treatment and Care for key Populations. Geneva: WHO; 2016. https://www.who.int/publications/i/item/9789241511124
  • 4. Huff HV, Carcamo PM, Diaz MM, et al. HIV and Substance Use in Latin America: A Scoping Review. Int J Environ Res Public Health 2022;19(12):7198.
  • 5. Kulu M, Özsoy F, Demir B. Inflammation levels in patients with alcohol and substance use disorders. Cukurova Med J 2021;46(4):1558-1565.
  • 6. Bahorik AL, Satre DD, Kline-Simon AH, Weisner CM, Campbell CC. Alcohol, Cannabis, and Opioid Use Disorders, and Disease Burden in an Integrated Healthcare System. J Addict Med 2017;11(1):3-9.
  • 7. Whiteford H, Degenhardt L, Rehm J, et al. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet 2013;382:1575-1586.
  • 8. Volkow N, Frieden T, Hyde P, Stephen S. Medication-assisted therapies-tackling the opioid-overdose epidemic. N Engl J Med 2014;370:2063-2066.
  • 9.D’Arrigo L, Goosdeel A. Avrupa Uyuşturucu ve Uyuşturucu Bağımlılığını İzleme Merkezi, Avrupa Uyuşturucu Raporu: trendler ve gelişmeler, Avrupa Toplulukları Resmi Yayınlar Bürosu, Lüksemburg: 2017. https://www.emcdda.europa.eu/system/files/publications/4541/TDAT17001TRN.pdf. Erişim tarihi: 04.09.2022.
  • 10. Amon JJ, Garfein RS, Ahdieh-Grant L, et al. Prevalence of hepatitis C virus infection among injection drug users in the United States, 1994–2004. Clin Infect Dis 2008;46:1852–1858
  • 11. Ferreira RC, Rodrigues FP, Teles SA, et al. Prevalence of hepatitis B virüs and risk factors in Brazilian non-injecting drug users. J Med Virol 2009;81:602–609.
  • 12. Grebely J, Larney S, Peacock A, et al. Global, regional, and country-level estimates of hepatitis C infection among people who have recently injected drugs. Addiction 2019;114:150-166.
  • 13. Trickey A, Fraser H, Lim AG, et al. The contribution of injection drug use to hepatitis C virus transmission globally, regionally, and at country level: a modelling study. Lancet Gastroenterol Hepatol 2019;4(6):435-444.
  • 14. Scheibe A, Young K, Moses L, et al. Understanding hepatitis B, hepatitis C and HIV among people who inject drugs in South Africa : findings from a three-city cross-sectional survey. Harm Reduct J 2019;16:1-11.
  • 15.Removille N, Origer A, Couffignal S, Vaillant M, Schmit JC, Lair ML. A hepatitis A, B, C and HIV prevalence and risk factor study in ever injecting and non-injecting drug users in Luxembourg associated with HAV and HBV immunisations. BMC Public Health. 2011;11:351.
  • 16.Ozkan H. Epidemiology of chronic hepatitis B in Turkey. Euroasian J Hepato Gastroenterology 2018;8:73–74.
  • 17.Ay B, Toklu MK, Sarıkamışlı M, Deniz F. Türkiye Uyuşturucu ve Uyuşturucu Bağımlılığı İzleme Merkezi, Türkiye Uyuşturucu Raporu: 2013. http://www.sck.gov.tr/wp-content/uploads/2020/02/2013-T%C3%BCrkiye-Uyu%C5%9Fturucu-Raporu.pdf . Erişim tarihi:01.09.2022.
  • 18.Karabulut N, Bulut Y, Telo S. Frequency of Hepatitis B and C Viruses, and HIV Among Drug Addicts in the Eastern Anatolia, Turkey. Jundishapur J Microbiol. 2015;8:e19698.
  • 19. Karabulut N, Catak Z. Frequency of Hepatitis B Virus, Hepatitis C Virus and Human Immunodeficiency Virus Infections in Cannabis and Opioid Addicts. Viral Hepat J. 2017;23:26-29.
  • 20. Des Jarlais DC, Diaz T, Perlis T, et al. Variability in the Incidence of Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus Infection among Young Injecting Drug Users in New York City. Am J Epidemiol. 2003;157:467-471.
  • 21. Allison RD, Conry-Cantilena C, Koziol D, et al. A 25-year study of the clinical and histologic outcomes of hepatitis C virus infection and its modes of transmission in a cohort of initially asymptomatic blood donors. J Infect Dis 2012;206:654-661.
  • 22. Yetim A, Şahin M. Hepatitis C virus (HCV) infection in youth with illicit drug use: sociodemographic evaluation and HCV genotype analysis. Klimik Derg 2018;31(3):190-194.
  • 23. Mutlu EA, Altıntoprak AE, Tokucoglu L. Seroprevalence of hepatitis B, hepatitis C, HIV and syphilis infections among non-injecting drug users. Anadolu Psikiyatri Dergisi 2015;16:65-68.
  • 24.Altuğlu İ, Tanyeri S, Zeytinoğlu A, Altıntoprak AE. HBsAg, Anti-HCV and Anti-HIV Seroprevalance Among Drug Users: a Retrospective Assessment. Arch Neuropsychiatry 2019;56:186-190.
  • 25.Mıstık R. Epidemiology of hepatitis C in Turkey. Tabak F, Tosun S, editors. Viral Hepatitis. Istanbul: Istanbul Tıp; 2013. p.83–112.
  • 26. Kruse GR, Barbour R, Heimer R, et al. Drug choice, spatial distribution, HIV risk, and HIV prevalence among injection drug users in St. Petersburg, Russia. Harm Reduct J 2009;6:22.
  • 27.Çatak Z, Üzmez E, Öztürk N, Uğur K, Aydın S. Rates of distribution of psychiatric disorders, hepatitis seroprevalence and illicit substance usage among adults aged 50 years and over in Turkey: a regional representative study. Anatolian Journal of Psychiatry 2019;20(6):635-641.
  • 28. Reynolds K, Pietrzak RH, El-Gabalawy R, Mackenzie CS, Sareen J. Prevalence of psychiatric disorders in US older adults: findings from a nationally representative survey. World Psychiatry 2015;14:74-81
  • 29.Demirci M, Çınar C, Eslek A, Orhan M, Akar ŞŞ. Evaluation of Anti-HCV Positivity in Patients Receiving Inpatient Treatment in a Mental Health Hospital in Turkey. J Tepecik Educ Res Hosp 2022;32(2):279-82.
  • 30.Alaei A, Alaei K, Waye K, Tracy M, Nalbandyan M, Mutlu E, Cetin MK. Hepatitis C infection and other drug-related harms among inpatients who injected drugs in Turkey. J Viral Hepat 2016; 24(6): 496-505.

TÜRKİYE'NİN DOĞUSUNDA BİR AMATEM KLİNİĞİNDE ALKOL VE MADDE KULLANAN HASTALARDA, HBsAg, Anti-HBs, Anti-HCV ve Anti-HIV Seroprevalansı: ALTI YILLIK RETROSPEKTİF DEĞERLENDİRME

Yıl 2022, Cilt 12, Sayı 6, 959 - 965, 30.11.2022
https://doi.org/10.16899/jcm.1189072

Öz

Amaç Madde kullanımı ve eşlik eden enfeksiyonlar önemli bir morbidite ve mortalite nedenidir. Ancak, ülkemizde madde kullananlarda bulaşıcı hastalıklar ile ilgili epidemiyolojik çalışmalar kısıtlıdır. Bu çalışmada, Türkiye'de bir AMATEM kliniğinde 2016-2021 yılları arasında yasa dışı madde kullanım sıklığının ve HBsAg, anti-HBs, anti-HCV ve anti-HIV parametrelerinin incelenmesi amaçlanmıştır. Gereç ve yöntem 6881 alkol ve madde kullanım bağımlısında (AMKB), HBsAg, anti-HBs, anti-HCV ve anti-HIV testleri ELISA tekniği ile çalışılmıştır. İdrar örnekleri, AMKB’lerden alkol, esrar ve kokain metabolitleri açısından analiz edilmiştir. Sonuçlar retrospektif olarak değerlendirilmiştir. Bulgular 6881 AMKB’nin tümü erkektir ve ortalama yaşları 32.18±9.66 yıldır. Çalışmaya dahil edilen 6881 AMKB’nın 4107’si(%59.7) opioid, 1479’u (%21.5) mix ilaç, 897’si (%13) alkol, diğerleri ise farklı yollarla madde kullanan bağımlılardan oluşmaktadır. Alkol kullananların yaş ortalamaları 45.33±13.03 ve opioid kullanıcılarının ise 29.90±7.13 idi. 2016 yılında opioid bağımlılığı %71,2 iken, 2021 yılında %28,7’ye düşmüştür. Bununla birlikte alkol bağımlılığı 2016 yılında %13,6 iken, 2021 yılında %21,4’e ve mix ilaç kullanımı ise 2016 yılında %8,7 iken 2021 yılında %36,8’e yükselmiştir. Opioid kullanıcıları arasında HBsAg pozitifliği (%56.7), esrar (%2.6) ve mix ilaç kullanıcılarından (%22.3) yüksek olarak tespit edilmiştir. Opioid kullanıcılarının anti-HCV pozitifliği (%69.4), alkol (%9.4), esrar (%2) ve mix ilaç kullanıcılarından (%16.2) yüksek ve istatistiksel olarak anlamlı bulunmuştur (p=0.0001). Opioid kullanıcılarının anti-HBs pozitifliği (%63.1), alkol (%9.9), esrar (%3) ve mix ilaç kullanıcılarından (%21) yüksek ve istatistiksel olarak anlamlı bulunmuştur (p=0.0001). Anti-HIV tüm AMKB hastalarda negatif olarak tespit edilmiştir. HbsAg, anti-HCV, anti-Hbs pozitifliği en yüksek oranlarda 26-30 yaş aralığında belirlenmiştir. Sonuç Bu veriler, bölgemizde özellikle 26-30 yaş grubunda yüksek damar içi madde kullanım yaygınlığını ve bu hasta grubunda, yüksek HBV, HCV oranlarını işaret etmektedir.

Kaynakça

  • 1.Herrmann ES, Matusiewicz AK, Stitzer ML, Higgins ST, Sigmon SC, Heil SH. Contingency Management Interventions for HIV, Tuberculosis, and Hepatitis Control Among Individuals With Substance Use Disorders: A Systematized Review. J Subst Abuse Treat 2017;72:117-125.
  • 2. Scheibe A, Young K, Versfeld A, et al. Hepatitis B, hepatitis C and HIV prevalence and related sexual and substance use risk practices among key populations who access HIV prevention, treatment and related services in South Africa: findings from a seven-city cross-sectional survey (2017). BMC Infectious Diseases 2020;20(1):655.
  • 3. World Health Organization. Consolidated guidelines on HIV prevention, diagnosis, treatment and Care for key Populations. Geneva: WHO; 2016. https://www.who.int/publications/i/item/9789241511124
  • 4. Huff HV, Carcamo PM, Diaz MM, et al. HIV and Substance Use in Latin America: A Scoping Review. Int J Environ Res Public Health 2022;19(12):7198.
  • 5. Kulu M, Özsoy F, Demir B. Inflammation levels in patients with alcohol and substance use disorders. Cukurova Med J 2021;46(4):1558-1565.
  • 6. Bahorik AL, Satre DD, Kline-Simon AH, Weisner CM, Campbell CC. Alcohol, Cannabis, and Opioid Use Disorders, and Disease Burden in an Integrated Healthcare System. J Addict Med 2017;11(1):3-9.
  • 7. Whiteford H, Degenhardt L, Rehm J, et al. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet 2013;382:1575-1586.
  • 8. Volkow N, Frieden T, Hyde P, Stephen S. Medication-assisted therapies-tackling the opioid-overdose epidemic. N Engl J Med 2014;370:2063-2066.
  • 9.D’Arrigo L, Goosdeel A. Avrupa Uyuşturucu ve Uyuşturucu Bağımlılığını İzleme Merkezi, Avrupa Uyuşturucu Raporu: trendler ve gelişmeler, Avrupa Toplulukları Resmi Yayınlar Bürosu, Lüksemburg: 2017. https://www.emcdda.europa.eu/system/files/publications/4541/TDAT17001TRN.pdf. Erişim tarihi: 04.09.2022.
  • 10. Amon JJ, Garfein RS, Ahdieh-Grant L, et al. Prevalence of hepatitis C virus infection among injection drug users in the United States, 1994–2004. Clin Infect Dis 2008;46:1852–1858
  • 11. Ferreira RC, Rodrigues FP, Teles SA, et al. Prevalence of hepatitis B virüs and risk factors in Brazilian non-injecting drug users. J Med Virol 2009;81:602–609.
  • 12. Grebely J, Larney S, Peacock A, et al. Global, regional, and country-level estimates of hepatitis C infection among people who have recently injected drugs. Addiction 2019;114:150-166.
  • 13. Trickey A, Fraser H, Lim AG, et al. The contribution of injection drug use to hepatitis C virus transmission globally, regionally, and at country level: a modelling study. Lancet Gastroenterol Hepatol 2019;4(6):435-444.
  • 14. Scheibe A, Young K, Moses L, et al. Understanding hepatitis B, hepatitis C and HIV among people who inject drugs in South Africa : findings from a three-city cross-sectional survey. Harm Reduct J 2019;16:1-11.
  • 15.Removille N, Origer A, Couffignal S, Vaillant M, Schmit JC, Lair ML. A hepatitis A, B, C and HIV prevalence and risk factor study in ever injecting and non-injecting drug users in Luxembourg associated with HAV and HBV immunisations. BMC Public Health. 2011;11:351.
  • 16.Ozkan H. Epidemiology of chronic hepatitis B in Turkey. Euroasian J Hepato Gastroenterology 2018;8:73–74.
  • 17.Ay B, Toklu MK, Sarıkamışlı M, Deniz F. Türkiye Uyuşturucu ve Uyuşturucu Bağımlılığı İzleme Merkezi, Türkiye Uyuşturucu Raporu: 2013. http://www.sck.gov.tr/wp-content/uploads/2020/02/2013-T%C3%BCrkiye-Uyu%C5%9Fturucu-Raporu.pdf . Erişim tarihi:01.09.2022.
  • 18.Karabulut N, Bulut Y, Telo S. Frequency of Hepatitis B and C Viruses, and HIV Among Drug Addicts in the Eastern Anatolia, Turkey. Jundishapur J Microbiol. 2015;8:e19698.
  • 19. Karabulut N, Catak Z. Frequency of Hepatitis B Virus, Hepatitis C Virus and Human Immunodeficiency Virus Infections in Cannabis and Opioid Addicts. Viral Hepat J. 2017;23:26-29.
  • 20. Des Jarlais DC, Diaz T, Perlis T, et al. Variability in the Incidence of Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus Infection among Young Injecting Drug Users in New York City. Am J Epidemiol. 2003;157:467-471.
  • 21. Allison RD, Conry-Cantilena C, Koziol D, et al. A 25-year study of the clinical and histologic outcomes of hepatitis C virus infection and its modes of transmission in a cohort of initially asymptomatic blood donors. J Infect Dis 2012;206:654-661.
  • 22. Yetim A, Şahin M. Hepatitis C virus (HCV) infection in youth with illicit drug use: sociodemographic evaluation and HCV genotype analysis. Klimik Derg 2018;31(3):190-194.
  • 23. Mutlu EA, Altıntoprak AE, Tokucoglu L. Seroprevalence of hepatitis B, hepatitis C, HIV and syphilis infections among non-injecting drug users. Anadolu Psikiyatri Dergisi 2015;16:65-68.
  • 24.Altuğlu İ, Tanyeri S, Zeytinoğlu A, Altıntoprak AE. HBsAg, Anti-HCV and Anti-HIV Seroprevalance Among Drug Users: a Retrospective Assessment. Arch Neuropsychiatry 2019;56:186-190.
  • 25.Mıstık R. Epidemiology of hepatitis C in Turkey. Tabak F, Tosun S, editors. Viral Hepatitis. Istanbul: Istanbul Tıp; 2013. p.83–112.
  • 26. Kruse GR, Barbour R, Heimer R, et al. Drug choice, spatial distribution, HIV risk, and HIV prevalence among injection drug users in St. Petersburg, Russia. Harm Reduct J 2009;6:22.
  • 27.Çatak Z, Üzmez E, Öztürk N, Uğur K, Aydın S. Rates of distribution of psychiatric disorders, hepatitis seroprevalence and illicit substance usage among adults aged 50 years and over in Turkey: a regional representative study. Anatolian Journal of Psychiatry 2019;20(6):635-641.
  • 28. Reynolds K, Pietrzak RH, El-Gabalawy R, Mackenzie CS, Sareen J. Prevalence of psychiatric disorders in US older adults: findings from a nationally representative survey. World Psychiatry 2015;14:74-81
  • 29.Demirci M, Çınar C, Eslek A, Orhan M, Akar ŞŞ. Evaluation of Anti-HCV Positivity in Patients Receiving Inpatient Treatment in a Mental Health Hospital in Turkey. J Tepecik Educ Res Hosp 2022;32(2):279-82.
  • 30.Alaei A, Alaei K, Waye K, Tracy M, Nalbandyan M, Mutlu E, Cetin MK. Hepatitis C infection and other drug-related harms among inpatients who injected drugs in Turkey. J Viral Hepat 2016; 24(6): 496-505.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Orjinal Araştırma
Yazarlar

Pinar ÖNER> (Sorumlu Yazar)
FETHİ SEKİN ŞEHİR HASTANESİ
0000-0001-9592-5986
Türkiye


Seda YILMAZ>
DEPARTMAN OF PSYCHIATRY, ISTINYE UNIVERSITY, ISTANBUL, TURKEY
0000-0002-4469-5807
Türkiye


Nülüfer KILIÇ>
DEPARTMENT OF PSYCHIATRY, ELAZIG MENTAL HEALTH HOSPITAL, ELAZIG, TURKEY.
0000-0001-7228-7459
Türkiye


Filiz ÖZSOY>
TOKAT GAZIOSMANPASA UNIVERSITY, SCHOOL OF MEDICINE
0000-0002-5198-8827
Türkiye

Erken Görünüm Tarihi 1 Ekim 2022
Yayımlanma Tarihi 30 Kasım 2022
Kabul Tarihi 16 Kasım 2022
Yayınlandığı Sayı Yıl 2022, Cilt 12, Sayı 6

Kaynak Göster

AMA Öner P. , Yılmaz S. , Kılıç N. , Özsoy F. SEROPREVALENCE OF HBsAg, Anti-HBs, Anti-HCV, and Anti-HIV IN PATIENTS WITH ALCOHOL AND SUBSTANCE ABUSE IN AN AMATEM CLINIC IN EASTERN TURKIYE: A SIX-YEAR RETROSPECTIVE EVALUATION. J Contemp Med. 2022; 12(6): 959-965.