Elsevier

Asian Journal of Psychiatry

Volume 6, Issue 6, December 2013, Pages 552-555
Asian Journal of Psychiatry

Seroprevalence of human immunodeficiency virus, Hepatitis B surface antigen, and Hepatitis C in substance dependents admitted in a tertiary hospital at Amritsar, India

https://doi.org/10.1016/j.ajp.2013.08.064Get rights and content

Abstract

Substance dependents often seek help for deaddiction and are detected positive during routine viral markers testing. We screened such patients in our hospital ShriGuru RamDas Institute of Medical Sciences and Research (SGRDIMSR) which is situated in a rural area adjoining the city of Amritsar; being a tertiary care centre it caters to a large population. A total of 1382 patients were admitted to the psychiatry ward from 01 July 2009 to 31 December 2012 and screened for study, out of whom 4.63% (n = 64) refused to consent for participation in the study. Out of 1318 screened participants, 85.96% (n = 1133) had opioid dependence, followed by tobacco (61.68%), alcohol (23.97%), cannabis (0.04%), and other substances (0.01%) including benzodiazepine, inhalants, etc. Out of 118 seropositive injection drug users (IDUs), 66.10% (n = 78) patients were Hepatitis C positive, 15.25% (n = 18) were detected as HIV reactive and 5.08% (n = 6) patients were found to be HBsAg positive. This is significant as HCV is mostly overlooked in government health policies and overshadowed by HIV. Our study also emphasises the need for HCV screening along with HIV in various health programmes. Our study is important as it may help in reviewing health policies as HIV infection among IDUs is highest (30.40%) in this part of the country as per data by UNAIDS (National AIDS Control Organisation, 2010) and there is no comprehensive policy for Hepatitis B and C like that of HIV.

Introduction

Substance dependents are known to be more prone to viral infections like HIV, Hepatitis B and Hepatitis C, mostly due to injection drug abuse. They often seek help for deaddiction and are detected positive during routine viral markers testing. Our hospital, ShriGuru RamDas Institute of Medical Sciences & Research (SGRDIMSR), is situated in a rural area adjoining the city of Amritsar and being a tertiary care centre, it caters to a large population. So, seroprevalence of HIV, Hepatitis B and Hepatitis C in patients getting admitted to our hospital for deaddiction may reflect a prevalence of these infections in substance dependents near Amritsar. Our study also emphasises the need for HCV screening along with HIV in various health programmes. Our study is important as it may help in reviewing health policies as HIV infection among injection drug users (IDU) is highest (30.40%) in this part of the country as per data by UNAIDS (National AIDS Control Organisation, 2010) yet there is no comprehensive policy for Hepatitis B and C like that of HIV.

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Materials and methods

All the cases admitted to the psychiatry ward of SGRDIMSR for deaddiction from 01 July 2009 to 31 December 2012 were given an option to participate in the study after an approval from the institutional ethics committee. Refusal to consent for participation in the study was an exclusion criterion. Participants were interviewed for socio-demographic information and general history, for which performa was filled. Following it, blood samples were taken for HIV, HBsAg, and HCV. HIV antibody

Results

A total of 1382 patients were admitted to the psychiatry ward and screened for study, out of whom 4.63% (n = 64) refused to consent for participation in the study. Out of the remaining 1318 patients, 86.34% (n = 1138) were in the 21–50 year age group and 76.78% (1012) were married. Mean age of all participants and IDUs was 32.26 and 30.04 years respectively with 11.31 and 10.58 years being mean age of duration of substance abuse respectively. All (100%) participants were male with rural background.

Discussion

One of the reasons for refusal to consent by 4.63% patients might be a previously known positive seroprevalence status and unwillingness to reveal it, or manifestation of high risk behaviour. It might have led to underestimation of seroprevalence. However, all patients were counselled regarding need to get viral marker status done. Our results show high percentage (90.7%) of farmers and unskilled labourers presenting for deaddiction which could be a reflection of local population distribution

Conflict of interest

All authors declare that no authors have any conflict of interest.

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