Seroprevalence of Hepatitis A, B, C, and D Markers and Liver Function Abnormalities in Intravenous Heroin Addicts

Abstract

To determine the most prevalent forms of hepatitis in intravenous heroin addicts, 389 addicts consecutively admitted to outpatient treatment clinics throughout California were tested for antibodies to hepatitis A (anti-HAV), B core (anti-HBc), B surface (anti-HBs), C (anti-HCV), D (anti-HDV), and B surface antigen (HBsAg). The majority were also tested for serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase, lactic dehydrogenase, total bilirubin, globulins, albumin, and platelet count. The seroprevalence of each marker was: anti-HAV (40.7%); anti-Hbc (73.6%); anti-HBs (46.7%); anti-HCV (93.6%); anti-HDV (9.6%), and HBsAg (3.5%). No single case was positive for IgM, anti-HAV, or for both HBsAg and anti-HDV, indicating the presence of recent hepatitis A or hepatitis D infection. Abnormal liver enzymes, serum proteins, total bilirubin, and platelet count were found to be normal in 5.3 to 44.8% of anti-HCV cases indicating persistent infection. Among anti-HCV cases, elevated total bilirubin or a low platelet count was invariably associated with one or more liver enzyme and protein abnormalities. We conclude that while acute hepatitis may be frequent and caused by various viral types, hepatitis C is the primary form of chronic hepatitis found in intravenous heroin addicts. Almost half of hepatitis C cases demonstrate liver function abnormalities indicating persistent infection that has the potential to be contagious and progress to cirrhosis, liver failure, and hepatocellular carcinoma.

Evaluation of Oxidative Markers, Apoptosis and Reproductive Efficiency in Heroin Addicted Rats

“…Liver damage from heroin has been proved in numerous studies worldwide (23)(24)(25)(26)(27)(28)(29)(30)(31) . The addiction of heroin or morphine affects the liver function enzyme as a whole (32) , but most of the studies concentrate on the evaluation of aminotransferases rather than phosphatase enzymes. Table (1) also summarizes the action of heroin addiction on the activity of serum G6PDH and LDH.…”

Heroin overdose: causes and consequences

“…Intravenous drug use is the most signi cant risk factor for hepatitis C. Estimates of the prevalence of HCV seropositivity range from 65% 68 to well over 90%. 69 . Chronic prevalence of HCV has been found to be greatest in males aged 20-39 with acute prevalence greatest in males aged 30-39 70 and infection with HCV is strongly associated with duration of IV drug use.…”

“…Chronic prevalence of HCV has been found to be greatest in males aged 20-39 with acute prevalence greatest in males aged 30-39 70 and infection with HCV is strongly associated with duration of IV drug use. 69 Thus some of the most signi cant risk factors for overdose (being male; aged in the late 20s and early 30s; intravenous use; a history of dependence) are also risk factors for hepatic infection and disease.…”

HIV-1 Coinfection and Morphine Coexposure Severely Dysregulate Hepatitis C Virus-Induced Hepatic Proinflammatory Cytokine Release and Free Radical Production: Increased Pathogenesis Coincides with Uncoordinated Host Defenses

“…Through the preferential activation of -opioid receptors, morphine influences a variety of physiological functions, including both innate and acquired immune responses (45,48), which can result in increased susceptibility for bacterial and viral infections (67). More importantly, activation of the -opioid receptor can trigger increased production of reactive oxygen species (ROS) and induction of apoptosis (21), and morphine-induced oxidative damage has been hypothesized to contribute to many of the systemic manifestations of liver disease and hepatotoxicity seen experimentally in mice (43,72), as well as in heroin abusers (59).…”