Skip to main content

Markers for hepatitis A, B and C in methadone maintained patients: an unexpectedly high co-infection with silent hepatitis B

Buy Article:

$51.00 plus tax (Refund Policy)



To determine the prevalence of hepatitis A, B and C viruses in patients attending a methadone maintenance clinic in New York City. Design 

Cross-sectional. Setting 

The Adult Services Clinic of Weill Cornell Medical College, an urban hospital-affiliated methadone program. Participants 

Former heroin addicted adults (n = 103) on methadone maintenance therapy. Measurements 

Markers for hepatitis A virus [HAV immunoglobulin M (IgM) and imunoglobulin G (IgG)], hepatitis B [hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb) and hepatitis B core antibody (HBcAb)] and hepatitis C virus (HCVAb). Serum alanine aminotransferase (ALT) and quantitative HCV RNA were also obtained. Qualitative detection of HBV DNA and HCV genotype were obtained in a subset of subjects. Findings 

More than 40% of subjects had markers for all three viruses. HCVAb was the most prevalent (83.5%), followed by HBcAb (65.0%), HAV IgG (46.1%) and HBsAb (41.1%). Hepatitis C RNA was detected in 70.6% of HCVAb positive subjects. While no subject had HBsAg, HBV DNA was detected in 26.4% of subjects who underwent this measure; all (n = 20) had HBcAb as their only HBV marker. The presence of HBV DNA did not influence ALT. Subjects with HCV RNA had higher ALTs than those without HCV RNA. Conclusions 

Most methadone-maintained subjects had at least one marker for viral hepatitis, with 41.8% having markers for HAV, HBV and HCV. A quarter of subjects had silent HBV infection, defined as the presence of HBV DNA in the absence of HBsAg. These subjects should be considered infectious and pose a public health risk.

Keywords: Hepatitis B; hepatitis C; methadone maintenance; occult infection; viral hepatitis

Document Type: Research Article


Affiliations: 1: The Laboratory of the Biology of Addictive Diseases, The Rockefeller University, NY, USA, 2: Department of Medicine, Fatebenefratelli Hospital Isola Tiberina, Rome, Italy, 3: Gastroenterology and Hepatology, Weill Cornell Medical College, NY, USA

Publication date: 2008-04-01

  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more