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Published Online: 14 September 2009

Characterization of the Emerging HIV Type 1 and HCV Epidemics among Injecting Drug Users in Dushanbe, Tajikistan

Publication: AIDS Research and Human Retroviruses
Volume 25, Issue Number 9

Abstract

This study aimed to determine HIV, HCV, and syphilis prevalence and correlates, and to characterize the molecular epidemiology of HIV-1 among injecting drug users (IDUs) in Dushanbe, Tajikistan. A cross-sectional study assessing risk factors for HIV and HCV through an interview administered survey was conducted. A total of 491 active adult IDUs were recruited from May to November 2004 in Dushanbe, Tajikistan. HIV-1 antibody status was determined with rapid testing and confirmed with ELISA. HCV antibody testing was conducted using a BIOELISA HCV kit. HIV-1 subtyping was done on a subset with full-length sequencing. Correlates of HIV and HCV infection were assessed using logistic regression. Overall prevalence of HIV was 12.1%, HCV was 61.3%, and syphilis was 15.7%. In a multivariate logistic regression model controlling for gender and ethnicity, daily injection of narcotics [odds ratio (OR) OR 3.22] and Tajik nationality (OR 7.06) were significantly associated with HIV status. Tajik nationality (OR 1.91), history of arrest (OR 2.37), living/working outside Tajikistan in the past 10 years (OR 2.43), and daily injection of narcotics (OR 3.26) were significantly associated with HCV infection whereas being female (OR 0.53) and always using a sterile needle (OR 0.47) were inversely associated with HCV infection. Among 20 HIV-1-positive IDU with specimens available for typing, 10 were subtype A, 9 were CRF02_AG, and one was an A-CRF02_AG recombinant. Epidemics of HIV-1, HCV, and drug use are underway in Dushanbe. The molecular epidemiology is distinctive, with West African variants accounting for roughly 50% of prevalent infections. Targeted prevention programs offering both needle exchange programs and opiate substitution therapies are urgently called for to prevent the further spread of HIV and HCV in Tajikistan.

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Published In

cover image AIDS Research and Human Retroviruses
AIDS Research and Human Retroviruses
Volume 25Issue Number 9September 2009
Pages: 853 - 860
PubMed: 19689193

History

Published online: 14 September 2009
Published in print: September 2009
Published ahead of print: 18 August 2009

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Authors

Affiliations

Chris Beyrer
Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland 21205.
Zeenat Patel
Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland 21205.
Julie A. Stachowiak
Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland 21205.
Farida K. Tishkova
Tajik Scientific and Research Institute of Prevention Medicine, Federal Virology Laboratory, Dushanbe, Tajikistan.
Mark A. Stibich
AIDS infoshare Russia, Dorozhny Proezd, dom 9/10, Moscow 113545, Russia.
Lindsay M. Eyzaguirre
Henry M. Jackson Foundation, 1401 Rockville Pike, Rockville, Maryland 20852.
Jean K. Carr
Henry M. Jackson Foundation, 1401 Rockville Pike, Rockville, Maryland 20852.
Vladimir Mogilnii
AIDS infoshare Russia, Dorozhny Proezd, dom 9/10, Moscow 113545, Russia.
Alena Peryshkina
AIDS infoshare Russia, Dorozhny Proezd, dom 9/10, Moscow 113545, Russia.
Alisher Latypov
Tajik Scientific and Research Institute of Prevention Medicine, Federal Virology Laboratory, Dushanbe, Tajikistan.
Steffanie A. Strathdee
University of California San Diego School of Medicine, San Diego, California 92093.

Notes

Address correspondence to:
Chris Beyrer
Department of Epidemiology
Johns Hopkins Bloomberg School of Public Health
615 N. Wolfe St. E7152
Baltimore, Maryland 21205
E-mail: [email protected].

Disclosure Statement

No competing financial interests exist.

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