Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

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

Beatrice Zovich
* ORCID logo ,
Catherine Freeland
ORCID logo ,
Holly Moore
,
Kara Sapp
ORCID logo ,
Anousha Qureshi
,
Rachel Holbert
,
Jason Zambrano
,
Daljinder Bhangoo
,
Chari Cohen
ORCID logo ,
Richard W. Hass
ORCID logo ,
Amy Jessop
Version 1 : Received: 1 April 2024 / Approved: 2 April 2024 / Online: 2 April 2024 (08:53:02 CEST)

A peer-reviewed article of this Preprint also exists.

Zovich, B.; Freeland, C.; Moore, H.; Sapp, K.; Qureshi, A.; Holbert, R.; Zambrano, J.; Bhangoo, D.; Cohen, C.; Hass, R.W.; Jessop, A. Dismantling Barriers to Hepatitis B and Delta Screening, Prevention, and Linkage to Care among the PWUD Community in Philadelphia. Viruses 2024, 16, 628. Zovich, B.; Freeland, C.; Moore, H.; Sapp, K.; Qureshi, A.; Holbert, R.; Zambrano, J.; Bhangoo, D.; Cohen, C.; Hass, R.W.; Jessop, A. Dismantling Barriers to Hepatitis B and Delta Screening, Prevention, and Linkage to Care among the PWUD Community in Philadelphia. Viruses 2024, 16, 628.

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%) were susceptible to HBV, 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.

Keywords

hepatitis B; hepatitis delta; people who use drugs; people who inject drugs; harm reduction; population health; viral hepatitis; liver cancer

Subject

Public Health and Healthcare, Public Health and Health Services

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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