Hepatitis B and C prevalence among heroin addicts in methadone maintenance treatment (MMT) and not in MMT in Pereira, Colombia

This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In a recent systematic review, Nelson et al showed that injection drug abuse is an important factor associated with a high prevalence of hepatitis C virus (HCV) and hepatitis B virus (HBV) infection [1]. In that review, only data from Argentina, Brazil, Mexico, Paraguay and Uruguay were included, due to the lack of information on other countries in Latin America and in the Caribbean. After an extensive literature search about the prevalence of injection drug use in Colombia, only four reports were found on three different Colombian cities. The prevalence of intravenous heroin administration in Medellin ranges between 0.2% in a prison population (VESPA Survey reported by Castaño) [2] and 24% in drug addiction treatment centers [3]. However, a comparison between both studies cannot be carried out due to differences in sample size, methodology and population evaluated. In Bucaramanga, the prevalence of intravenous illegal drug use in three drug rehabilitation centers and one prison was 4.2% [4]. Finally, a survey carried out on 895 inhabitants from Pereira showed a prevalence of intravenous drug use of 26.9%, including the use of heroin and cocaine [5] (Figure 1). Hepatitis C virus (HCV) testing and counseling are important strategies to potentially reduce HCV transmission in young adult injection drug users [6]. However, in developing countries, the health systems underappreciate the role of injection drug users (IDU) in the transmission of infectious agents such as HCV, hepatitis B virus (HBV) and human immunodeficiency virus (HIV). Moreover, the treatment of HCV infection in IDU is still low in developing countries due to patient-and system-related barriers. Although HCV infection is a public health problem around the world and chronic viral hepatitis are the major etiological factors of end-stage liver diseases, in Colombia there are no studies of HCV and HBV prevalence in IDU. The prevalence of HCV in multi-transfused patients is 9% [7], whereas a more recent study carried out in 697 inhabitants from four different states showed a frequency of anti-HCV markers of 3.55% [8]. On the other hand, the prevalence of HBV in Colombia ranges between 1.97 and 8.39% in several regions [8-10]. As part of an ongoing work evaluating the immune status of IDU and a control population in Pereira, Colombia (approved by the …