Surveillance of HIV, Hepatitis B Virus, and Hepatitis C Virus in an Estonian Injection Drug–Using Population: Sensitivity and Specificity of Testing Syringes for Public Health Surveillance
1Department of Public Health, University of Tartu, Estonia; 2Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut; 3Department of Preventive Medicine and Community Health, State University of New York Downstate Medical Center, Brooklyn, and 4Department of Epidemiology, School of Public Health, University at Albany, State University of New York, Albany, New York
Surveillance of bloodborne infections among injection drug users (IDUs) can be accomplished by determining the presence of pathogen markers in used syringes. Parallel testing of returned syringes and venous blood from IDUs was conducted to detect antibodies to human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). Syringe surveillance for HIV yielded a sensitivity and specificity of 92% and 89%, respectively, and provided a reasonable estimate of the prevalence of HIV among participants. Because sensitivity for HBV (34%) and HCV (55%) was low, syringe testing may be useful for surveillance of hepatitis over time but not for estimation of prevalence.
Received 8 July 2005; accepted 29 August 2005; electronically published 22 December 2005.
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Online publication date: 1-Oct-2008.
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Potential conflicts of interest: none reported.
Financial support: Estonian Science Foundation (grant 5526); Fogarty International Center, National Institutes of Health (grant D43 TW00233); National Institute on Drug Abuse (grant R01‐DA014713 to R.H.).