A multicentre sero-behavioural survey for hepatitis B and C, HIV and HTLV among people who inject drugs in Germany using respondent driven sampling

BMC Public Health

Osamah Hamouda⁶  Claudia Kücherer⁴  Claus-Thomas Bock⁷  Norbert Bannert⁴  Boris-Alexander Ratsch⁵  Oumaima Stambouli¹  R Stefan Ross¹  Claudia Santos-Hövener⁶  Stine Nielsen⁶  Benjamin Wenz⁶  Astrid Leicht²  Dirk Schäffer³  Ulrich Marcus⁶  Ruth Zimmermann⁶ 

[1] Institute of Virology, National Reference Centre for Hepatitis C, University Hospital Essen, University of Duisburg-Essen, Essen, Germany;Fixpunkt, Berlin, Germany;Deutsche AIDS-Hilfe, Berlin, Germany;Department of Infectious Diseases, Division for HIV and other Retroviruses, Robert Koch Institute, Berlin, Germany;Takeda Pharma Vertrieb GmbH & Co. KG, Jägerstrasse 27, 10117 Berlin, Germany;Department for Infectious Disease Epidemiology, Division for HIV/AIDS, STI and Blood-borne Infections, Robert Koch Institute, Berlin, Germany;Department of Infectious Diseases, Division for Viral Gastroenteritis and Hepatitis Pathogens and Enteroviruses, Robert Koch Institute, Berlin, Germany

关键词: Injecting drug users;    Second generation surveillance;    Respondent driven sampling;    HTLV;    HIV;    hepatitis C;    hepatitis B;    Sero- and behavioural survey;    PWID;   

Others  :  1128331
DOI  :  10.1186/1471-2458-14-845

 received in 2014-07-14, accepted in 2014-07-25,  发布年份 2014

【 摘 要 】

Background

People who inject drugs are at high risk for hepatitis B, hepatitis C and HIV. HTLV was reported by neighboring countries to be prevalent in this population, but the situation for Germany is unclear. To generate seroprevalence and related behavioural data and to enhance prevention efforts against these infections for drug users in Germany, a multicentre sero- and behavioural survey was initiated. People who inject drugs are not well reached by services for testing and counselling for blood-borne infections in Germany. An interventional part of the study is intended to prove feasibility and acceptance of testing and counselling in low-threshold drop-in settings.

Methods/Design

Between May 2011 and March 2015, eligible participants (persons having injected drugs within the last 12 months, aged 16 years+, and living in the study city) are recruited by respondent driven sampling, using low-threshold drop-in facilities as study-sites in eight German cities with large drug scenes. Calculated sample size is 2,033 participants. Capillary blood samples collected as dried blood spots are anonymously tested for serological and molecular markers of hepatitis B and C, HIV, and HTLV I and II. A detailed face-to-face-interview about hepatitis- and HIV-related knowledge, former testing, imprisonment, sexual and injecting risk behaviour is conducted with participants. Staff is trained to offer pre- and post-test-counselling of blood-borne infections and HIV rapid testing to participants.

Discussion

We chose respondent driven sampling for recruitment of participants to improve representativeness of results. Persons, who are not reached by the facility where the study is conducted, are aimed to be included by recruitment through their personal social network of injecting drug users. To reduce differential biases in the questions on knowledge of transmission and prevention of infections, we present true statements on hepatitis B, C and HIV, their possible routes of transmission and measures of prevention to participants. Participants are told that the statements are true and are asked to answer if they knew this fact already or if it is new to them. In case of knowledge gaps they are offered free targeted counselling as well as free HIV rapid testing and post-test counselling of HIV and hepatitis test results.

【 授权许可】

   
2014 Zimmermann et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]World Health Organization: Hepatitis B - Fact sheet N°204. Geneva: WHO; 2013. [http://www.who.int/mediacentre/factsheets/fs204/en/ webcite]
• [2]Nelson PK, Mathers BM, Cowie B, Hagan H, Des Jarlais D, Horyniak D, Degenhardt L: Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews. Lancet 2011, 378(9791):571-583.
• [3]Poethko-Muller C, Zimmermann R, Hamouda O, Faber M, Stark K, Ross RS, Thamm M: Epidemiology of hepatitis A, B, and C among adults in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1). Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz 2013, 56(5–6):707-715.
• [4]Stark K, Bienzle U, Vonk R, Guggenmoos-Holzmann I: History of syringe sharing in prison and risk of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus infection among injecting drug users in Berlin. Int J Epidemiol 1997, 26(6):1359-1366.
• [5]Brack J: Die Hepatitiden B und C bei drogenabhängigen Patienten: Eine epidemiologische Studie. Suchttherapie 2002, 2002(3 Suppl 1):3-10.
• [6]Williams R: Global challenges in liver disease. Hepatology 2006, 44(3):521-526.
• [7]Shepard CW, Finelli L, Alter MJ: Global epidemiology of hepatitis C virus infection. Lancet Infect Dis 2005, 5(9):558-567.
• [8]Kamili S, Krawczynski K, McCaustland K, Li X, Alter MJ: Infectivity of hepatitis C virus in plasma after drying and storing at room temperature. Infect Control Hosp Epidemiol 2007, 28(5):519-524.
• [9]Doerrbecker J, Behrendt P, Mateu-Gelabert P, Ciesek S, Riebesehl N, Wilhelm C, Steinmann J, Pietschmann T, Steinmann E: Transmission of hepatitis C virus among people who inject drugs: viral stability and association with drug preparation equipment. J Infect Dis 2013, 207(2):281-287.
• [10]Doerrbecker J, Friesland M, Ciesek S, Erichsen TJ, Mateu-Gelabert P, Steinmann J, Steinmann J, Pietschmann T, Steinmann E: Inactivation and survival of hepatitis C virus on inanimate surfaces. J Infect Dis 2011, 204(12):1830-1838.
• [11]Paintsil E, He H, Peters C, Lindenbach BD, Heimer R: Survival of hepatitis C virus in syringes: implication for transmission among injection drug users. J Infect Dis 2010, 202(7):984-990.
• [12]Reimer J, Lorenzen J, Baetz B, Fischer B, Rehm J, Haasen C, Backmund M: Multiple viral hepatitis in injection drug users and associated risk factors. J Gastroenterol Hepatol 2007, 22(1):80-85.
• [13]Backmund M, Meyer K, Wächtler M, Eichenlaub D: Hepatitis C virus infection in injection drug users in Bavaria: risk factors for seropositivity. Eur J Epidemiol 2003, 18(6):563-568.
• [14]Thane K, Wickert C, Verthein U: Abschlussbericht: Szenebefragung in Deutschland 2008. Hamburg: Institut für interdisziplinäre Suchtforschung,- ISD; 2009.
• [15]Roy K, Hay G, Andragetti R, Taylor A, Goldberg D, Wiessing L: Monitoring hepatitis C virus infection among injecting drug users in the European Union: a review of the literature. Epidemiol Infect 2002, 129:577-585.
• [16]Wiessing L, Likatavicius G, Hedrich D, Guarita B, van de Laar MJ, Vicente J: Trends in HIV and hepatitis C virus infections among injecting drug users in Europe, 2005 to 2010. Eurosurveillance 2011, 16(48):9-13.
• [17]Stark K, Schreier E, Müller R, Wirth D, Driesel G, Bienzle U: Prevalence and determinants of anti-HCV seropositivity and of HCV genotype among intravenous drug users in Berlin. Scand J Infect Dis 1995, 27(4):331-337.
• [18]Robert Koch-Institut (RKI): Zur Situation bei wichtigen Infektionskrankheiten in Deutschland: Virushepatitis C im Jahr 2012. Epid Bull 2013, 30:273-284.
• [19]Jauffret-Roustide M, Le Strat Y, Couturier E, Thierry D, Rondy M, Quaglia M, Razafandratsima N, Emmanuelli J, Guibert G, Barin F: A national cross-sectional study among drug-users in France: epidemiology of HCV and highlight on practical and statistical aspects of the design. BMC Infect Dis 2009, 9(1):113. BioMed Central Full Text
• [20]Hope VD, Hickman M, Ngui SL, Jones S, Telfer M, Bizzarri M, Ncube F, Parry JV: Measuring the incidence, prevalence and genetic relatedness of hepatitis C infections among a community recruited sample of injecting drug users, using dried blood spots. J Viral Hepat 2011, 18(4):262-270.
• [21]Crofts N, Aitken CK: Incidence of bloodborne virus infection and risk behaviours in a cohort of injecting drug users in Victoria in 1990–1995. Med J Aust 1997, 167(1):17-20.
• [22]Maher L, Jalaludin B, Chant KG, Jayasuriya R, Sladden T, Kaldor JM, Sargent PL: Incidence and risk factors for hepatitis C seroconversion in injecting drug users in Australia. Addiction 2006, 101(10):1499-1508.
• [23]Joint United Nations Programme on HIV/AIDS (UNAIDS): UNAIDS Report on the Global AIDS Epidemic 2013. Geneva: UNAIDS; 2013. [http://www.unaids.org/en/media/unaids/contentassets/documents/epidemiology/2013/gr2013/UNAIDS_Global_Report_2013_en.pdf webcite]
• [24]European Centre for Disease Prevention and Control, WHO Regional Office for Europe: HIV/AIDS Surveillance in Europe 2010. Stockholm: European Centre for Disease Prevention and Control (ECDC); 2011.
• [25]Robert Koch-Institut: Weiterführende Analysen zur HIV-Inzidenz- und -Prävalenzschätzung 2012. Epidemiologisches Bulletin-Robert Koch Institut 2013, 45:1-12.
• [26]Proietti FA, Carneiro-Proietti ABF, Catalan-Soares BC, Murphy EL: Global epidemiology of HTLV-I infection and associated diseases. Oncogene 2005, 24(39):6058-6068.
• [27]Laperche S, Worms B, Pillonel J: Blood safety strategies for human T-cell lymphotropic virus in Europe. Vox Sang 2009, 96(2):104-110.
• [28]de la Fuente L, Toro C, Soriano V, Brugal MT, Vallejo F, Barrio G, Jimenez V, Silva T, Project Itinere Working Group: HTLV infection among young injection and non-injection heroin users in Spain: prevalence and correlates. J Clin Virol 2006, 35(3):244-249.
• [29]Abad M, Dronda F, Dominguez E, Moreno S, Vallejo A: HTLV-2b among HIV type 1-coinfected injecting drug users in Spain. AIDS Res Hum Retroviruses 2011, 27(5):579-583.
• [30]Egan JF, O’Leary B, Lewis MJ, Mulcahy F, Sheehy N, Hasegawa H, Fitzpatrick F, O’Connor JJ, O’Riordan J, Hall WW: High rate of human T lymphotropic virus type IIa infection in HIV type 1-infected intravenous drug abusers in Ireland. AIDS Res Hum Retroviruses 1999, 15(8):699-705.
• [31]Silva AF, Almeida C, Martins HC, Coutinho R, Leitao E, Silva R, Paixao MT, Padua E: Prevalence and molecular characterization of human T cell leukemia virus type 2 in a group of intravenous drug users coinfected with HIV type 1 in Portugal. AIDS Res Hum Retroviruses 2005, 21(4):249-255.
• [32]Malm K, Ekermo B, Hillgren K, Britton S, Fredlund H, Andersson S: Prevalence of human T-lymphotropic virus type 1 and 2 infection in Sweden. Scand J Infect Dis 2012, 44(11):852-859.
• [33]Taylor GP, Bodeus M, Courtois F, Pauli G, Del Mistro A, Machuca A, Padua E, Andersson S, Goubau P, Chieco-Bianchi L, Soriano V, Coste J, Ades AE, Weber JN: The seroepidemiology of human T-lymphotropic viruses: types I and II in Europe: a prospective study of pregnant women. J Acquir Immune Defic Syndr 2005, 38(1):104-109.
• [34]Ellerbrok H, Fleischer C, Vandamme AM, Kucherer C, Pauli G: Sequence analysis of two HTLV type I infections imported to Germany. AIDS Res Hum Retroviruses 1997, 13(14):1255-1258.
• [35]European Centre for Disease Prevention and Control: HTLV-I/II transmission by tissue/cell transplantation. Part 1: epidemiological review. In Technical Report. Stockholm: ECDC; 2012:47.
• [36]European Centre for Disease Prevention and Control: Evidence for the effectiveness of interventions to prevent infections among people who inject drugs; Part 1: needle and syringe programmes and other interventions for prevention hepatitis C, HIV and injecting risk behaviour. In Technical Report. Stockholm: ECDC; 2011.
• [37]European Centre for Disease Prevention and Control: Evidence for the effectiveness of interventions to prevent infections among people who inject drugs; Part 2: drug treatment for preventing hepatitis C, HIV and injecting risk behaviour. In Technical Report. Stockholm: ECDC; 2011.
• [38]Wodak A, Cooney A: Do needle syringe programs reduce HIV infection among injecting drug users: a comprehensive review of the international evidence. Subst Use Misuse 2006, 41(6–7):777-813.
• [39]Tilson H, Aramrattana A, Bozzette S, Celentano D, Falco M, Hammett T: PreventingHIV infection among injecting drug users in high-risk countries: an assessment of the evidence. Washington, D.C: National Academy of Sciences, Institute of Medicine; 2006.
• [40]Verthein U, Haasen C, Reimer J: Switching from methadone to diamorphine: 2-year results of the german heroin-assisted treatment trial. Subst Use Misuse 2011, 46(8):980-991.
• [41]UNAIDS/WHO Working Group on Global HIV/AIDS and STI Surveillance: Guidelines for Second Generation HIV Surveillance. Geneva: WHO; 2000.
• [42]European Monitoring Centre for Drugs and Drug Addiction: An overview of the drug-related infectious diseases (DRID) key indicator. Version, 20091. Lisbon: EMCDDA; 2009. http://www.emcdda.europa.eu/publications/methods/drid-overview webcite
• [43]European Monitoring Centre for Drugs and Drug Addiction and Greek REITOX Focal Point, University Mental Health Research Insitute (UMHRI): Protocol for the implementation of EMCDDA key indicator drug related infectios disease. Lisbon: EMCDDA; 2006. [Draft version October 2006] [http://www.emcdda.europa.eu/html.cfm/index65537EN.html webcite
• [44]Wiessing L, Bravo MJ: DRID guidance module: behavioural indicators for people who inject drugs. Lisbon: EMCDDA; 2013. [Version 1.0, 2013]
• [45]Heckathorn DD: Respondent-driven sampling: a new approach to the study of hidden populations. Soc Probl 1997, 44(2):174-199.
• [46]Magnani R, Sabin K, Saidel T, Heckathorn D: Review of sampling hard-to-reach and hidden populations for HIV surveillance. AIDS 2005, 19(Suppl 2):S67-S72.
• [47]Heckathorn DD: Respondent-driven sampling II: deriving valid population estimates from chain-referral samples of hidden populations. Soc Probl 2002, 49(1):11-34.
• [48]Kraus L, Heppekausen K, Tretter F: Prävalenzschätzungen von Opiatkonsumenten in deutschen Großstädten: Methoden und Ergebnisse. SUCHT 2004, 50(1):11-20.
• [49]Johnston LG, Prybylski D, Raymond HF, Mirzazadeh A, Manopaiboon C, McFarland W: Incorporating the service multiplier method in respondent-driven sampling surveys to estimate the size of hidden and hard-to-reach populations: case studies from around the world. Sex Transm Dis 2013, 40(4):304-310.
• [50]Johnston L, Saumtally A, Corceal S, Mahadoo I, Oodally F: High HIV and hepatitis C prevalence amongst injecting drug users in Mauritius: findings from a population size estimation and respondent driven sampling survey. Int J Drug Policy 2011, 22(4):252-258.
• [51]Sarrazin C, Berg T, Ross R, Schirmacher P, Wedemeyer H, Neumann U, Schmidt H, Spengler U, Wirth S, Kessler H: Update der S 3-Leitlinie Prophylaxe, Diagnostik und Therapie der Hepatitis-C-Virus(HCV)-infektion. Z Gastroenterol 2010, 48:289-351.
• [52]Ross RS, Stambouli O, Gruner N, Marcus U, Cai W, Zhang W, Zimmermann R, Roggendorf M: Detection of infections with hepatitis B virus, hepatitis C virus, and human immunodeficiency virus by analyses of dried blood spots-performance characteristics of the ARCHITECT system and two commercial assays for nucleic acid amplification. Virol J 2013, 10(72):72.
• [53]Volz E, Wejnert C, Cameron S, Spiller M, Barash V, Degani I, Heckathorn DD: Respondent-Driven Sampling Analysis Tool (RDSAT) Version 7.1. Ithaca, NY: Cornell University; 2012.
• [54]Prinzleve M, Müller O, Werse B, Bernard C: MoSyD Szenestudie - Die offene Drogenszene in Frankfurt am Main. Frankfurt am Main: Centre for Drug Research (CDR); 2004:61.
• [55]Toan NL, le Song H, Kremsner PG, Duy DN, Binh VQ, Koeberlein B, Kaiser S, Kandolf R, Torresi J, Bock CT: Impact of the hepatitis B virus genotype and genotype mixtures on the course of liver disease in Vietnam. Hepatology 2006, 43(6):1375-1384.
• [56]Sarrazin C, Berg T, Ross RS, Schirmacher P, Wedemeyer H, Neumann U, Schmidt HHJ, Spengler U, Wirth S, Kessler HH: Update der S 3-Leitlinie Prophylaxe, Diagnostik und Therapie der Hepatitis-C-Virus (HCV)-Infektion, AWMF-Register-Nr.: 021/012 (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V.). Z Gastroenterol 2010, 48:289-351.
• [57]Cornberg M, Protzer U, Petersen J, Wedemeyer H, Berg T, Jilg W, Erhardt A, Wirth S, Sarrazin C, Dollinger M: Aktualisierung der S 3-Leitlinie zur Prophylaxe, Diagnostik und Therapie der Hepatitis-B-Virusinfektion. Z Gastroenterol 2011, 49:871-930.
• [58]Tamura K, Peterson D, Peterson N, Stecher G, Nei M, Kumar S: MEGA5: molecular evolutionary genetics analysis using maximum likelihood, evolutionary distance, and maximum parsimony methods. Mol Biol Evol 2011, 28(10):2731-2739.
• [59]Bernard C, Werse B, Schell-Mack C: MoSyD Jahresbericht 2012 Drogentrends in Frankfurt am Main. Frankfurt am Main: Goethe Universität Frankfurt am Main, Centre For Drug Research (CDR); 2013.
• [60]Mills HL, Colijn C, Vickerman P, Leslie D, Hope V, Hickman M: Respondent driven sampling and community structure in a population of injecting drug users, Bristol UK. Drug Alcohol Depend 2012, 126(3):324-332.
• [61]Malekinejad M, Johnston LG, Kendall C, Kerr LR, Rifkin MR, Rutherford GW: Using respondent-driven sampling methodology for HIV biological and behavioral surveillance in international settings: a systematic review. AIDS Behav 2008, 12(4 Suppl):S105-S130.
• [62]Deutsche AIDS-Hilfe e.V, AIDS-Hilfe Dortmund, Fachhochschule Dortmund: Projekt TEST IT – Evaluationsbericht. Berlin: Deutsche AIDS-Hilfe; 2010. [http://www.aidshilfe.de/sites/default/files/_TEST_IT_Endbericht_final_0.pdf webcite]
• [63]Deutsche AIDS-Hilfe e.V: Infomappe für die Beratung in Aidshilfen 2013. Berlin: Deutsche AIDS-Hilfe; 2013. [http://www.aidshilfe.de/de/shop/archiv/3862 webcite]