Issue: November 2019

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September 11, 2019
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HBV exposure 4 times higher among female vs. male meth users

Issue: November 2019
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The likelihood of hepatitis B virus exposure among methamphetamine users was four times higher in women compared with men, according to a recent study published in the Journal of Infectious Diseases.

Researchers also cited poverty, injection drug use and hepatitis C infection as other factors for increased risk for infection.

“Hepatitis B is a significant public health problem worldwide, with over 350 million chronic carriers globally, and an estimated 850,000 to 2.2 million individuals in the United States. Although the leading cause of chronic infection worldwide is through vertical transmission, in the U.S., the most common mode of transmission is horizontal,” Stacy R. Tressler, MPH, a student worker in the department of epidemiology at West Virginia University, and colleagues wrote. “About 50% of people chronically infected are unaware of their infection and remain a source of ongoing transmission.”

The researchers examined 847 participants in the National Health and Nutrition Examination Survey, a cross-sectional survey conducted by the CDC’s National Center for Health Statistics, which evaluates health and nutritional status of the U.S. population. Specifically, the researchers looked at participants who answered “yes” to ever using cocaine, heroin or methamphetamine and, consequently, “yes” to using methamphetamine between 2009 and 2016 and underwent testing for HBV.

The findings demonstrated that the odds of HBV exposure for women who reported using methamphetamine was four times higher than that of men (adjusted OR = 3.83, 95% CI, 1.65-8.90). The results “highlight the importance of screening for substance use including methamphetamine, as well as testing and vaccinating for HBV among reproductive-age women to prevent mother-to-child transmission of HBV during pregnancy,” according to Tressler and colleagues.

Additionally, researchers found that living below the poverty threshold (aOR = 3.17, 95% CI, 1.39-7.21), injection drug use (aOR = 4.89, 95% CI, 1.95-12.26), active hepatitis C infection (aOR = 3.39, 95% CI, 1.10-12.26) and identifying as men who have sex with men (aOR = 28.21, 95% CI, 5.19-153.38) were significantly associated with HBV exposure. Additionally, a bivariate analysis showed that the odds of HBV exposure among participants reporting using methamphetamine 50 or more times was five times higher when compared with those who used five or less times, suggesting an increased risk of exposure with increased use.

“As methamphetamine use continues to rise, it is important to identify those at highest risk of acquiring hepatitis B infections in order to target testing and vaccination programs. The estimated number of susceptible participants who reported using methamphetamine in this study suggests a need to provide targeted vaccination efforts in this potentially at-risk population,” the authors wrote. “Harm reduction programs should incorporate testing for HBV and vaccination to help reduce the disease burden among this high-risk group.”– by Caitlyn Stulpin

Disclosures: Tressler reports no relevant financial disclosures. Please see the full study for all other author’s disclosures.