This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ochnio, J. J.
Right arrow Articles by Dobson, S. R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ochnio, J. J.
Right arrow Articles by Dobson, S. R.
Related Collections
Right arrow Other epidemiology
Right arrow Liver (including hepatitis and cirrhosis)
Right arrow Lesbian, bisexual, gay, transgendered health
Right arrow Vaccination
Right arrow Drug misuse
CMAJ • August 7, 2001; 165 (3)
© 2001 Canadian Medical Association or its licensors

Research
Recherche

Past infection with hepatitis A virus among Vancouver street youth, injection drug users and men who have sex with men: implications for vaccination programs

Jan J. Ochnio*, David Patrick{dagger}, Margaret Ho*, Douglas N. Talling* and Simon R. Dobson*

From the *Vaccine Evaluation Center, British Columbia's Children's Hospital and the University of British Columbia, and the {dagger}University of British Columbia Centre for Disease Control, Vancouver, BC.

Correspondence to: Dr. Jan J. Ochnio, Vaccine Evaluation Center, Rm 317A, 950 W 28th Ave., Vancouver BC V5Z 4H4; fax 604 875-2496; jochnio{at}interchange.ubc.ca

Background: In Canada, inactivated hepatitis A vaccines are targeted selectively at those at increased risk for infection or its complications. In order to evaluate the need for routine hepatitis A vaccination programs in Vancouver for street youth, injection drug users (IDUs) and men who have sex with men (MSM), we determined the prevalence of antibodies against hepatitis A virus (HAV) and risk factors for HAV in these groups.

Methods: The frequency of past HAV infection was measured in a sample of Vancouver street youth, IDUs and MSM attending outreach and STD clinics and needle exchange facilities by testing their saliva for anti-HAV immunoglobulin G. A self-administered, structured questionnaire was used to gather sociodemographic data. Stepwise logistic regression was used to evaluate the association between presumed risk factors and groups and past HAV infection.

Results: Of 494 study participants, 235 self-reported injection drug use, 51 were self-identified as MSM and 111 met street youth criteria. Positive test results for anti-HAV were found in 6.3% of street youth (95% confidence interval [CI] 2.6%–12.6%), 42.6% (95% CI 36.2%–48.9%) of IDUs and 14.7% (95% CI 10.4%–19.1%) of individuals who denied injection drug use. Among men who denied injection drug use, the prevalence was 26.3% (10/38) for MSM and 12% (21/175) for heterosexuals. Logistic regression showed that past HAV infection was associated with increased age and birth in a country with high rates of hepatitis infection. Injection drug use among young adults (25–34 years old) was a significant risk factor for a positive anti-HAV test (p = 0.009). MSM were also at higher risk for past HAV infection, although this association was nominally significant (p = 0.07).

Interpretation: Low rates of past HAV infection among Vancouver street youth indicate a low rate of virus circulation in this population, which is vulnerable to hepatitis A outbreaks. An increased risk for HAV infection in IDUs and MSM supports the need to develop routine vaccination programs for these groups also.




This article has been cited by other articles:


Home page
 JAMAHome page
E. Roy, N. Haley, P. Leclerc, B. Sochanski, J.-F. Boudreau, and J.-F. Boivin
Mortality in a Cohort of Street Youth in Montreal
JAMA, August 4, 2004; 292(5): 569 - 574.
[Abstract] [Full Text] [PDF]

Home page
 CMAJHome page
D. W. Scheifele and J. Ochnio
Hepatitis A vaccine: Is it being used to best advantage?
Can. Med. Assoc. J., July 1, 2002; 167(1): 44 - 45.
[Full Text] [PDF]