Differential seroprevalences of hepatitis C virus, hepatitis B virus and human immunodeficiency virus among intravenous drug users, commercial sex workers and patients with sexually transmitted diseases in Chiang Mai, Thailand

To elucidate the differences in the mode of transmission of three blood-borne viruses, hepatitis C virus (HCV), hepatitis B virus (HBV) and human immunodeficiency virus (HIV), under comparable conditions of study, we analyzed the prevalences of anti-HCV antibodies (anti-HCV), anti-HBV core antibodies (anti-HBc), HBV surface antigen (HBsAg) and anti-HIV antibodies (anti-HIV) in different risk populations in Chiang Mai, Thailand, where the prevalence of HIV infection is high. The subjects consisted of 98 intravenous drug users (IVDU), 100 commercial sex workers (CSW) and 50 male patients with sexually transmitted diseases (STD). In IVDU the prevalence of anti-HCV was the highest (85%), followed by anti-HBc (77%) and anti-HIV (46%), whereas in CSW and STD the prevalence of anti-HCV was 2 and 0%, respectively, that of anti-HBc 69 and 64%, respectively, and that of anti-HIV 11 and 14%, respectively. The prevalence of anti-HBc minus that of HBsAg, representing horizontal transmission of HBV, was similar for IVDU (63%), CSW (58%) and STD (64%). Thus, HCV is mainly transmitted by blood contact, HIV primarily by blood contact rather than by sexual contact, and HBV equally readily by blood or sexual contact. These findings were supported by the results of logistic regression analysis.