Prevalence of HAV Ab, HEV (IgG), HSV2 IgG, and Syphilis Among Sheltered Homeless Adults in Tehran, 2012

Document Type: Original Article

Authors

1 Virology Research Group, Pasteur institute of Iran, Tehran, Iran

2 Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran

4 Center for Disease Control, Ministry of Health and Medical Education, Tehran, Iran

5 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

6 HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

7 Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran

Abstract

Background
This study investigated the prevalence for hepatitis A virus (HAV), hepatitis E virus (HEV), herpes simplex virus type 2 (HSV2) and syphilis among homeless in the city of Tehran.
 
Methods
In this cross-sectional study, 596 homeless were recruited in Tehran. A researcher-designed questionnaire was used to study demographic data. Using enzyme-linked immunoassay, and rapid plasma reagin (RPR) test, we evaluated the seroprevalence of HAV anti-body, HEV IgG, herpes, HSV2 IgG, and syphilis among sheltered homeless in Tehran. The associations between the participant’s characteristics and infections were evaluated using logistic regression and chi-square.
 
Results
A total of 569 homeless, 78 women (13.7%) and 491 men (86.3%) were enrolled into the study from June to August 2012. Their age mean was 42 years and meantime of being homeless was 24 months. Seroprevalence of syphilis, HEV IgG, HSV2 IgG and HAV Ab was 0.55%, 24.37%, 16.48%, and 94.34%, respectively. History of drug abuse was reported in 77.70%; 46.01% of them were using a drug during the study and 26.87% of them had history of intravenous drug abuse. Among people who had intravenous drug abuse, 48.25% had history of syringe sharing.
 
Conclusion
The prevalence of HAV, HEV and HSV2 were higher than the general population while low prevalence of syphilis was seen among homeless peoples who are at high risk of sexually transmitted infection (STD). Our findings highlighted that significant healthcare needs of sheltered homeless people in Tehran are unmet and much more attention needs to be paid for the health of homeless people.

Keywords

Main Subjects


  1. Raoult D. Infection in homeless people. Lancet Infect Dis. 2012;12(11):822-823. DOI:10.1016/S1473-3099(12)70186-X
  2. Aliverdinia A, Pridemore WA. Individual-level factors contributing to homelessness among adult males in Iran. Sociological Spectrum. 2012;32(3):209-225.
  3. Raoult D, Foucault C, Brouqui P. Infections in the homeless. Lancet Infect Dis. 2001;1(2):77-84. DOI:10.1016/S1473-3099(01)00062-7
  4. Doosti-Irani A, Mokhaeri H, Chegini Sharafi A, et al. Prevalence of HIV, HBV, and HCV and related risk factors amongst male homeless people in Lorestan province, the west of Iran. J Res Health Sci. 2017;17(1):E1-E6.
  5. Badiaga S, Richet H, Azas P, et al. Contribution of a shelter-based survey for screening respiratory diseases in the homeless. Eur J Public Health. 2009;19(2):157-160. DOI:10.1093/eurpub/ckn142
  6. Beijer U, Wolf A, Fazel S. Prevalence of tuberculosis, hepatitis C virus, and HIV in homeless people: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12(11):859-870. DOI:10.1016/S1473-3099(12)70177-9
  7. Kaba M, Brouqui P, Richet H, et al. Hepatitis E virus infection in sheltered homeless persons, France. Emerg Infect Dis. 2010;16(11):1761-1763.
  8. Noell J, Rohde P, Ochs L, et al. Incidence and prevalence of chlamydia, herpes, and viral hepatitis in a homeless adolescent population. Sex Transm Dis. 2001;28(1):4-10.
  9. León P, Venegas E, Bengoechea L, et al. Prevalence of infections by hepatitis B, C, D and E viruses in Bolivia. Rev Panam Salud Publica. 1999;5(3):144-151.
  10. Whitley RJ, Roizman B. Herpes simplex virus infections. Lancet. 2001;357(9267):1513-1518.
  11. Fenton KA, Breban R, Vardavas R, et al. Infectious syphilis in high-income settings in the 21st century. Lancet Infect Dis. 2008;8(4):244-53. DOI:10.1016/S1473-3099(08)70065-3
  12. Tobian AA, Quinn TC. Herpes simplex virus type 2 and syphilis infections with HIV: an evolving synergy in transmission and prevention. Curr Opin HIV AIDS. 2009;4(4):294. DOI:10.1097/COH.0b013e32832c1881
  13. Bagheri Amiri F, Gouya MM, Saifi M, et al. Vulnerability of homeless people in Tehran, Iran, to HIV, tuberculosis and viral hepatitis. PloS One. 2014;9(6):e98742. DOI:10.1371/journal.pone.0098742
  14. Freeman EE, Weiss HA, Glynn JR, Cross PL, Whitworth JA, Hayes RJ. Herpes simplex virus 2 infection increases HIV acquisition in men and women: systematic review and meta-analysis of longitudinal studies. Aids. 2006;20(1):73-83.
  15. Rezaei-Chaparpordi S, Assmar M, Amirmozafari N, et al. Seroepidemiology of herpes simplex virus type 1 and 2 in northern iran. Iran J Public Health. 2012;41(8):75.
  16. Orang M, Asmar M. Seroreversion of serological tests for syphilis in the disabled community in Mazandaran province of Iran. Iran J Infect Dis Trop Med. 2002;7:22-26.
  17. Pourfathollah AA. Changes in frequency of HBV, HCV, HIV and syphilis infections among blood donors in Tehran province 2005–2011. Arch Iran Med. 2014;17(9):613.
  18. Farhoudi B, Kamali K, Rajabpoor Z. Situation analysis of sexually transmitted infections in the Islamic Republic of Iran. Tehran: Ministry of Health and Medical Education; 2008.
  19. Vahdani P, Hosseini-Moghaddam S-M, Family A, Moheb-Dezfouli R. Prevalence of HBV, HCV, HIV and syphilis among homeless subjects older than fifteen years in Tehran. Arch Iran Med. 2009;12(5):483-487.
  20. Vahdani P, Hosseini-Moghaddam S-M, Gachkar L, Sharafi K. Prevalence of hepatitis B, hepatitis C, human immunodeficiency virus, and syphilis among street children residing in southern Tehran, Iran. Arch Iran Med. 2006;9(2):153-155.
  21. Kazerooni PA, Motazedian N, Motamedifar M, et al. The prevalence of human immunodeficiency virus and sexually transmitted infections among female sex workers in Shiraz, South of Iran: by respondent-driven sampling. Int J STD AIDS. 2014;25(2):155-161. DOI:10.1177/0956462413496227
  22. Navadeh S, Mirzazadeh A, Mousavi L, Haghdoost A, Fahimfar N, Sedaghat A. HIV, HSV2 and syphilis prevalence in female sex workers in Kerman, South-East Iran; using respondent-driven sampling. Iran J Public Health. 2012;41(12):60-65.
  23. Pinto VM, Tancredi MV, Alencar HD, et al. Prevalence of syphilis and associated factors in homeless people of Sao Paulo, Brazil, using a rapid test. Rev Bras Epidemiol. 2014;17(2):341-354.
  24. Mohebbi SR, Nejad MR, Tahaei SME, et al. Seroepidemiology of hepatitis A and E virus infections in Tehran, Iran: a population based study. Trans R Soc Trop Med Hyg. 2012;106(9):528-531. DOI:10.1016/j.trstmh.2012.05.013
  25. Taghavi SA, Hosseini Asl MK, Talebzadeh M, Eshraghian A. Seroprevalence study of hepatitis A virus in Fars province, southern Iran. Hepat Mon. 2011;11(4):285-288.
  26. Ataei B, Nokhodian Z, Javadi AA, et al. Hepatitis E virus in Isfahan province: a population-based study. Int J Infect Dis. 2009;13(1):67-71.
  27. Smith HM, Reporter R, Rood MP, et al. Prevalence study of antibody to ratborne pathogens and other agents among patients using a free clinic in downtown Los Angeles. J Infect Dis. 2002;186(11):1673-1676. DOI:10.1086/345377