Intravenous (IV) drug abuse is one of important transmission modes of human immunodeficiency virus (HIV) infection. IV drug abuse in HIV epidemics is frequent in western countries. In Korea, however, no case has been definitely identified although possibility of such infection route does exist considering rising number of IV drug use (IDU). Recently, we have experienced a case of HIV infection by IDU. We herein offer the case with review of literature.
HIV Infections* ; HIV* ; Korea ; Substance Abuse, Intravenous* ; Substance-Related Disorders

Intravenous (IV) drug abuse is one of important transmission modes of human immunodeficiency virus (HIV) infection. IV drug abuse in HIV epidemics is frequent in western countries. In Korea, however, no case has been definitely identified although possibility of such infection route does exist considering rising number of IV drug use (IDU). Recently, we have experienced a case of HIV infection by IDU. We herein offer the case with review of literature.
HIV Infections* ; HIV* ; Korea ; Substance Abuse, Intravenous* ; Substance-Related Disorders

OBJECTIVETo confirm the close relationship of high co-infection rate between HIV and hepatitis virus in intravenous drug users (i.v.DUs).

METHODSAnti-HIV, HBV and HCV were detected by ELISA in the serum from 35 scattered and 15 massed i.v.DUs. PCR and RT-PCR were performed to confirm the infection of HIV, HBV, HCV, HGV and TTV among the 15 massed intravenous drug abusers.

RESULTSAmong the 50 i.v.DUs, the positive rates of anti-HCV1 HBsAg, anti-HBe and anti-HBc were 92% (46/50), 12% (6/50), 10% (5/50) and 66% (33/50), respectively. In the samples of HBsAg positive, their HBeAg was also positive. Although the positive rate of serum markers was different in the massed i.v.DUs compared to the scattered i.v.DUs, no significant difference was shown. In the cases of massed i.v.DUs, the positive rates of HIV DNA, HBV-DNA, HCV-RNA, HGV-RNA, and TTV-DNA were 100% (15/15), 26.6% (4/15), 53.3% (8/15), 33.3% (5/15) and 26.6% (4/15), respectively. Among the 15 massed intravenous drug users, one was infected with HIV, HBV, HCV, HGV and TTV; two were infected with HIV, HBV, HCV and HGV; three were infected only with HIV; and the remaining had other forms of co-infection.

CONCLUSIONThe co-infection rate of HIV, HBV, HCV, HGV and TTV in intravenous drug users is very high.

HIV Infections ; complications ; Hepatitis, Viral, Human ; complications ; Humans ; Substance Abuse, Intravenous ; complications

Endophthalmitis ; diagnosis ; etiology ; Humans ; Klebsiella pneumoniae ; pathogenicity ; Male ; Middle Aged ; Substance Abuse, Intravenous ; complications

OBJECTIVETo estimate the number of drug users in Hongjiang, Hunan and to develop strategy for drug reduction in the future.

METHODSTwo capture-recapture methods were used to estimate the numbers of drug addicts. Random stratified sampling survey was used to verify the optimum allocation. The first capture-recapture method (CR1) referred to the number from optimum allocation random stratified sampling survey conducted in the communities and the number from local Public Security Bureau list being the second capture. The second capture-recapture method (CR2) referred to the collection of records in the detoxification unit with an interval of 4 months. The estimated number was calculated under Seber's adjustment formula. Face to face interview was carried out during the optimum allocation random stratified sampling survey process.

RESULTSOf 1388 interviewed in the communities, 24 (1.73%) were identified as drug addicts under the optimum allocation random stratified sampling survey. When the figure 1.73% was applied to the total population (72,709) in Hongjiang, the result yielded an estimation of 1258 drug addicts. The estimated numbers of CR1 and CR2 were 904 and 1069 respectively. However, the number was 1.3 to 1.6 fold higher than the reported number (687) by local Public Security Bureau.

CONCLUSIONThe capture-recapture method seemed a better method in estimating the number of drug addicts.

China ; epidemiology ; Female ; Humans ; Incidence ; Male ; Needle Sharing ; Population Surveillance ; methods ; Substance Abuse, Intravenous ; epidemiology

OBJECTIVETo study HIV, HBV and HCV infections in intravenous drug users.

METHODS2025 blood samples from intravenous drug users were collected from Sichuan, Hunan, Guangxi and Xinjiang regions, and tested for anti-HIV, anti-HCV, HBsAg using enzyme-linked immuno-sobent assays (ELISAs).

RESULTSThe positive rates of anti-HIV,anti-HCV and HBsAg were14.7%-30.4%, 60.7%-85.5% and 6.6%-22.4% in the intravenous drug users, respectively. The co-infection rates of HIV/HBV, HIV/HCV, HCV/HBV and HIV/HCV/HBV were 0%-0.4%, 11.6%-27.2%, 2.3%-14.3% and 1.6%-4.8% respectively in this population.

CONCLUSIONThe infection rates of HIV, HBV and HCV were higher in the intravenous drug users than that in general populations in the same regions, and HIV/HCV co-infection appeared most frequent in this population.

China ; epidemiology ; HIV Infections ; epidemiology ; Hepatitis B ; epidemiology ; Hepatitis C ; epidemiology ; Humans ; Prevalence ; Substance Abuse, Intravenous

No abstract available.
Health Personnel/*ethics ; Humans ; Hypnotics and Sedatives/*adverse effects ; Propofol/*adverse effects ; Substance Abuse, Intravenous/*etiology

INTRODUCTIONInjecting drug abusers are vulnerable to many infectious complications. We describe a case of tetanus in a Singaporean who regularly abused buprenorphine.

CLINICAL PICTUREA 49-year-old male was hospitalised for progressive generalised spasms associated with dysarthria and opisthotonus. Tetanus was diagnosed clinically.

TREATMENTSupportive management was instituted in the intensive care unit (ICU). Toxicology samples tested positive for buprenorphine.

OUTCOMEHe recovered rapidly and was transferred out of the ICU after 8 days. Retrospective questioning confirmed parenteral abuse of buprenorphine.

CONCLUSIONThis case highlights an uncommon and potentially lethal complication of parenteral drug abuse.

Buprenorphine ; Disease Progression ; Dysarthria ; Humans ; Male ; Middle Aged ; Singapore ; Substance Abuse, Intravenous ; Substance-Related Disorders ; complications ; Tetanus ; diagnosis ; etiology ; therapy

INTRODUCTIONWe present a retrospective descriptive study of cases admitted to Tan Tock Seng Hospital from March 2005 to October 2005 with complications of Subutex abuse.

CLINICAL PICTUREA total of 8 patients were studied. Of the 8, 7 were male and one was female. Their complications consist of the following: arterial pseudoaneurysm (2), arterial pseudoaneurysm with infective venous thrombus (1), infective venous thrombus (1), venous thrombus (2), end arterial spasms (1) and sympathetic dystrophy (1).

TREATMENTFor the patient who presented with buprenorphine-associated neuropathy, non-operative treatment with analgesics was given. Conservative medical therapy involving deep venous thrombosis treatment was instituted for the patient with deep venous thrombosis. Repair, restorative bypass and embolectomy surgery were performed for patients who had severe embolic/thrombotic complications. One of the patients who received the above surgery required amputation of his lower limb.

OUTCOMEOf the 8 patients, 4 were treated medically, 3 required surgery and 1 required amputation. Their recoveries were uneventful. Of the 8, 1 absconded and was not followed up with.

CONCLUSIONParenteral injection of buprenorphine can cause a wide range of vascular complications from simple vascular irritation to severe infective thrombosis and pseudoaneurysms requiring limb amputations. Non-sterile preparation of an injected substance or non-sterile injection sites and the repeated punctures of major vessels are possible culprits in those who are seen to have acute infection of injection sites.

Abscess ; etiology ; Adult ; Aneurysm, False ; etiology ; Buprenorphine ; Female ; Femoral Artery ; Groin ; Humans ; Male ; Middle Aged ; Substance Abuse, Intravenous ; complications

In recent years increased studies on the relationship between addictive drugs abuse and infectious diseases such as acquired immunodeficiency syndrome (AIDS) have shown that these drugs, including heroin, marijuana and cocaine, not only alter the abusers' neuropsychological and pathophysiological responses, but also impair their immune functions. The possible mechanisms may include the direct effect on immune cells or an indirect method ( e. g., stimulation of the hypothalamus-pituitary-adrenal axis). The correlation between intravenous drug users (IVDUs) and human immunodeficiency virus infections has led to the proposal that the immunomodulation mediated by additive drugs is a major factor contributing to the progression of AIDS in IVDUs. Immunosuppression caused by drug abuse may increase the susceptibility to opportunistic infections, while drug abusers' lifestyles also increase exposure risk to infectious pathogens. In summary, increased infection risks and drug-mediated immunomodulation increase drug abusers' susceptibility to infectious pathogens.
Disease Susceptibility ; Humans ; Immune System ; drug effects ; physiology ; Infection ; etiology ; Narcotics ; adverse effects ; Substance Abuse, Intravenous ; complications