Evidence of multiple hepatitis virus infections in autopsied materials of intravenous drug addicts.

Injection of illicit drugs is an important risk factor for acquiring parenterally transmitted viral infections. To investigate the prevalence of viral mono- and co-infections in intravenous drug uses (IDUs) postmortem and to evaluate the risk of potential infection to personnel involved in medicolegal practice a total number of 59 known IDUs were tested during necropsy for serological markers of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) as well as for the nucleic acids of the hepatitis B and C viruses, and the GB virus C (GBV-C), in blood and in the liver. Our findings showed that 90.2% cases were positive for at least one or more serological markers of the tested viruses. Seroprevalence rates of anti-HCV, HBsAg and anti-HIV were 78.4%, 32.4% and 29.7% respectively. Of the IDUs tested for serological infection markers 43.2% were positive for one, 40.5% for two and 5.4% for all three markers. Viral nucleic acids were detected in the sera of 64.4% and in the liver of 81.4% of the cases. HCV, RNA, GBV-C RNA and HBV DNA were found in 33.9%, 28.8% amd 28.8% of the serum samples and in 67.8%, 35.6% and 28.8% of the liver tissue, respectively. Active viral co-infections or triple infections were detectable in the sera of 20.3% and in the liver of 39% of the case. Results show that the sensitivity of viral nucleic acid testing postmortem strongly depends on the quality and source of material used.