HIV and viral hepatitis (HBV and HCV) among four vulnerable groups in Lebanon
Abstract number: P1203
Ramia S., Mahfoud Z., Afifi R., Dejong J., Kreidieh K., Shamra S., Kassak K.
Objectives: AIDS-related policies and programs in the Middle East and North Africa (MENA) region are highly constrained by the lack of accurate information about the full scale of the HIV epidemic. Recently we conducted an integrated bio-behavioral surveillance study among four major vulnerable groups in Lebanon, namely prisoners, men who have sex with men (MSM), female sex workers (FSWs) and injecting drug users (IDUs). One of our aims in this study was to provide an estimate of HIV prevalence as well as an estimate of HBV and HCV prevalence and their co-infection with HIV in these populations. Furthermore, the distribution of HCV genotypes was conducted among the anti-HCV positive IDUs and the immune status of HBV infection was evaluated among MSM and FSWs.
Methods: Two types of sampling methods were utilized: simple random sampling for recruiting the prisoners in Roumyeh Prison and respondent driven sampling to target MSM, FSWs and IDUs. Blood samples were collected as dried blood spots and then eluted to be tested for HIV, HBV and HCV by ELISA. Anti-HCV positive IDUs' samples were subjected to RNA extraction followed by qualitative detection and genotyping.
Results: A total of 580 prisoners, 101 MSM, 103 FSWs and 106 IDUs participated in study. Prisoners showed a significantly higher seroprevalence of HBV (1.7%) and HCV (3.4%) than reported in the general population. Only 1 prisoner (0.17%) was confirmed as anti-HIV-positive. Among the MSM, only 1 (0.99%) was HBsAg carrier and 1 (0.99%) was confirmed anti-HIV positive. No HCV cases were detected in this population and only 10% of the MSM were immune to HBV. Regarding FSWs, none were infected with HIV, HBV or HCV and 30% were immune to HBV. Among IDUs, 56 (52.8%) were anti-HCV-positive with Genotype 3 the predominant one (57.1%) followed by genotype 1 (21%). 3 (2.8%) IDUs were HBsAg carriers and 1 (0.9%) was confirmed as anti-HIV-positive. None of the 3 HIV-positive patients was co-infected with HBV or HCV.
Conclusion: Although HIV does not seem to be a major problem among the four high-risk groups studied in Lebanon however, HBV and HCV seem to pose a serious health concern. Our results highlight the urgent need to raise awareness among prisoners, MSM, FSWs and IDUs and their health care providers of the availability and benefits of HBV vaccination in Lebanon. In addition, and due to the absence of vaccines against HCV and HIV, education programs aiming at behavioral changes should be intensified.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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