Dismantling Barriers to Hepatitis B and Delta Screening, Prevention, and Linkage to Care among the PWUD Community in Philadelphia

Authors

Beatrice Zovich
Catherine Freeland
Holly Moore
Kara Sapp
Anousha Qureshi
Rachel Holbert
Jason Zambrano
Daljinder Bhangoo, Thomas Jefferson UniversityFollow
Chari Cohen
Richard W. Hass, Thomas Jefferson UniversityFollow
Amy Jessop

Document Type

Article

Publication Date

4-18-2024

Comments

This article is the author's final published version in Viruses, Volume 16, Issue 4, April 2024, Article number 628.

The published version is available at https://doi.org/10.3390/v16040628.

Copyright © 2024 by the authors

Abstract

The prevalence of hepatitis B and delta viruses (HBV/HDV) among people who use drugs (PWUD) remains largely unknown. In the context of one Philadelphia-based harm reduction organization (HRO), this study aimed to assess HBV/HDV prevalence and facilitate linkage to care. Participants completed a demographic HBV/HDV risk factor survey and were screened for HBV and reflexively for HDV if positive for HBV surface antigen or isolated core antibody. Fisher's exact tests and regression were used to understand relationships between risks and HBV blood markers. Of the 498 participants, 126 (25.3%) did not have hepatitis B immunity, 52.6% had been vaccinated against HBV, and 17.9% had recovered from a past infection. Eleven (2.2%) participants tested positive for isolated HBV core antibody, 10 (2.0%) for HBV surface antigen, and one (0.2%) for HDV antibody. History of incarceration was associated with current HBV infection, while transactional sex and experience of homelessness were predictive of previous exposure. This study found high rates of current and past HBV infection, and a 10% HBV/HDV co-infection rate. Despite availability of vaccine, one quarter of participants remained vulnerable to infection. Findings demonstrate the need to improve low-threshold HBV/HDV screening, vaccination, and linkage to care among PWUD. The study also identified gaps in the HBV/HDV care cascade, including lack of point-of-care diagnostics and lack of support for HROs to provide HBV services.

Recommended Citation

Zovich, Beatrice; Freeland, Catherine; Moore, Holly; Sapp, Kara; Qureshi, Anousha; Holbert, Rachel; Zambrano, Jason; Bhangoo, Daljinder; Cohen, Chari; Hass, Richard W.; and Jessop, Amy, "Dismantling Barriers to Hepatitis B and Delta Screening, Prevention, and Linkage to Care among the PWUD Community in Philadelphia" (2024). College of Population Health Faculty Papers. Paper 195.
https://jdc.jefferson.edu/healthpolicyfaculty/195

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.

Language

English