Pravalenz von hepatitis B, hepatitis C und HIV-infektionen bei drogentodesfallen in Hamburg (1985 bis 1997) unter berucksichtigung von epidemiologischen, forensischen und morphologischen aspekten

The prevalence of hepatitis B, hepatitis C and HIV infections among drug abuse-related fatalities in Hamburg (1985-1997) was investigated with respect to epidemiological, forensic and morphological aspects. The purpose of this study was (1) to determine the prevalence of hepatitis B (HBV), hepatitis C (HCV) and HIV infections among drug abuse-related fatalities (drug deaths) in Hamburg from 1985 to 1997, (2) to assess the rate of multiple infections and (3) to analyze the liver histomorphology in 100 autopsied drug deaths. Furthermore, we discuss the epidemiological and forensic aspects. In this period 1469 drug deaths were registered with a prevalence for HBV of 35% (1997: 39%), for HCV 51% (1997: 58%), and for HIV 7% (1997: 15%). Co- infections were common (28%) and 19% of all cases were infected with HBV and HCV. The liver histology showed that hepatitis was frequently diagnosed (74%) and was associated with HBV and/or HCV infections (77% of all hepatitis cases). Only 9% showed a normal liver histology. Forensic autopsies and monitoring of HBV, HCV and HIV infections in drug deaths represent an important tool to gain information about the individual case and the situation among i.v. drug abusers.