HIV and HBV infection in intravenous drug addicts from northeastern Italy

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Abstract
Three hundred and two intravenous drug addicts (IVDA) from five towns in Northeastern Italy were studied. Of the males, 37/249 (14.8%) were homosexuals and of the females, 29/53 (54.7%) were prostitutes; 118 (39.0%) were alcoholics. AST levels were abnormal in 31.876, ALT in45.7%, GTP in 36.4%, and bilirubin in 14.6%. The prevalence of HBsAg (13.9%) and HBeAg (21.4% of HBsAg positive) was significantly higher than in 2,983 controls (4.2% and 6.3%. p < .001 and p < .02, respectively). Of the HBsAg posi:ive subjects, 51.7% had anti‐HDV antibodies. Among 260 HBsAg negative cases, 146 (56.2%) were anti‐HBs and anti‐HBc positive, 76 (29.2%) were anti‐HBc positive and anti‐HBs negative (25 anti‐HBe positive and 51 anti‐HBe negative), and 38 had no HBV markers. Anti‐HIV ELISA positive subjects came to 70.5% (triplicate determination with absolute concordance) and Western blot analysis confirmed the results in 99.1% of ELISA positive and 100% of ELISA negative subjects. The prevalence of anti‐HIV was significantly higher in anti‐HBc positive than negative cases (p < .02), even excluding HBsAg positive subjects. Cases negative for HIV and HBV had a significantly lower median duration of drug abuse than those with past or present infection (36 vs 60 months, p < .001). HIV‐related diseases were present in 56.3% of the cases (120/213; PGL in 94, ARC in 24, and AIDS in two). The absolute T4 + cell count correlated inversely with the prevalence and severity of HIV‐related diseases‐9/10 had less than 400 T4+ cells/ml (one PGL, seven ARC, and one AIDS), 33/47 had 400‐800 T4+ cells/ml (27 PGL, five ARC, and one AIDS), and 25/40 had over 800 T4+ cells/ml (25 PGL). Geographical differences were observed in the distribution of the ratio between symptomatid infected cases.