Burden of blood transmitted infections in substance users admitted for inpatient treatment in Singapore and the associated factors

Singapore Med J. 2015 Feb;56(2):87-91. doi: 10.11622/smedj.2014199.

Abstract

Introduction: There is paucity of local data on the prevalence of blood transmitted infections (BTIs), such as hepatitis B, hepatitis C and human immunodeficiency virus (HIV) infections, among illicit drug users. This study aimed to examine the prevalence of BTIs among substance dependent inpatients and identify the factors associated with BTIs.

Methods: We conducted a retrospective analysis of clinical notes of 170 inpatients with a diagnosis of substance dependence who were admitted at the National Addictions Management Service, Singapore, between 1 June 2009 and 31 May 2010.

Results: Majority of the 170 inpatients were male (88.2%) and Chinese (58.2%). The mean age of the patients was 43.1 years, and the main drug of abuse was opioids (86.5%). BTIs were found in 70 (41.2%) inpatients; the prevalence of hepatitis B, hepatitis C and HIV infections was 3.7%, 39.6% and 0%, respectively. Lifetime intravenous drug use, but not needle-sharing, was more common among inpatients who were positive for BTIs (p < 0.01). Logistic regression analysis showed that lifetime intravenous drug use (OR 4.3, 95% CI 1.7- 10.8, p < 0.01) was the only significant predictor of BTIs.

Conclusion: A large proportion (41.2%) of the substance users seeking help was positive for at least one BTI. Lifetime intravenous drug users were found to be more than four times more likely to have a BTI. Early detection and prevention is essential to improve prognosis.

MeSH terms

  • Adult
  • Analgesics, Opioid / therapeutic use
  • Female
  • HIV Infections / blood
  • HIV Infections / complications
  • Hepatitis B / blood
  • Hepatitis B / complications
  • Hepatitis C / blood
  • Hepatitis C / complications
  • Humans
  • Inpatients*
  • Male
  • Middle Aged
  • Needle Sharing
  • Odds Ratio
  • Prevalence
  • Prognosis
  • Retrospective Studies
  • Singapore
  • Substance Abuse, Intravenous / blood*
  • Substance Abuse, Intravenous / complications*
  • Substance Abuse, Intravenous / epidemiology

Substances

  • Analgesics, Opioid