Exposure to hepatitis B and C and to HTLV-1 and 2 among Israeli drug abusers in Jerusalem.

The incidence of exposure to hepatitis B (HBV) and C (HCV) viruses and to that of HTLV 1 and 2 were investigated in a group of 181 illicit drug users attending a drug rehabilitation centre in Jerusalem. In this predominantly male group, 28% were intravenous drug abusers (IVDAs) and 72% non-IVDAs; 92% of the individuals were of Middle Eastern descent (of which 40% were of a Moroccan descent). Antibodies to hepatitis C virus (anti-HCV) were found in 54% of the IVDAs compared with 4.5% in the non-IVDAs (p < 0.001), indicating the presence of a significant reservoir of HCV among this IVDA group. Evidence for previous hepatitis B (HBV) infection was found in 26% of the IVDAs and 33% of the non-IVDAs (p = NS) with no HbSAg positivity. The similar prevalence of previous HBV infection in both drug abuser groups, which was also observed when the groups were analysed according to their ethnic origin, suggests that a vertical transmission of HBV rather than an exclusive association with intravenous drug abuse may have been the source of exposure to HBV. HTLV-1 rates were 2% among IVDAs and 0% among non-IVDAs (p = NS). No serologic evidence for HTLV-2 was detected in this cohort. The present study supports previous observations in other countries and indicates the exceptionally high prevalence of HCV infection among Israeli i.v. drug abusers. It also suggests that using HBV seropositivity as an indicator for needle exchange among drug abusers may be of limited value in geographic areas where vertical transmission of HBV is common. HCV antibodies might become more suitable markers for this purpose.