Surveillance of HIV and viral hepatitis by analysis of samples from drug related deaths

Eur J Epidemiol. 2006;21(5):383-7. doi: 10.1007/s10654-006-9009-x. Epub 2006 Jun 9.


Objectives: To determine the prevalence of antibodies against HIV, hepatitis B (HBV) and hepatitis C (HCV) in postmortem samples from drug related deaths (DRDs) in Denmark.

Design: Prospective cohort study. Postmortem samples tested for anti-HIV, anti-HCV anti-HBc and anti-HBs. Comparison to pre-mortem testing when possible. DRDs were searched for in the national register of drug treatment, national prison registers, and the national infectious disease register.

Setting: National level.

Participants: Drug related deaths admitted to Danish Institutes of Forensic Medicine during 2004.

Main outcome measures: Prevalence of antibodies, injection drug use, drug treatment experience and prevalence of cirrhosis.

Results: Samples for analysis were obtained from 78% (233/299) of DRDs. The prevalences of anti-HIV, anti-HCV and anti-HBc were 4% (9/214), 51% (110/215), and 35% (74/209), indicating a persisting low prevalence of HIV and a declining prevalence of HCV and HBV. Injecting ever was detected among 45% of DRDs and this was associated with a significantly higher prevalence of hepatitis B and C. Among the DRDs 56% received drug treatment and 12% had cirrhosis at autopsy. Evidence of vaccination against HBV was found among 16% (21/128).

Conclusions: Monitoring of viral hepatitis and HIV among DRDs is feasible, and our survey indicates a falling prevalence among Danish drug users. Surveillance based on drug users in treatment may overestimate the true prevalence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use
  • Autopsy
  • Denmark / epidemiology
  • Female
  • HIV / drug effects
  • HIV / physiology
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Infections / mortality*
  • HIV Infections / virology
  • Hepacivirus / drug effects
  • Hepacivirus / physiology
  • Hepatitis B / complications*
  • Hepatitis B / drug therapy
  • Hepatitis B / mortality*
  • Hepatitis B / virology
  • Hepatitis B virus / drug effects
  • Hepatitis B virus / physiology
  • Hepatitis C / complications*
  • Hepatitis C / drug therapy
  • Hepatitis C / mortality*
  • Hepatitis C / virology
  • Humans
  • Male
  • Middle Aged
  • Registries
  • Substance-Related Disorders / complications*
  • Substance-Related Disorders / mortality*


  • Antiviral Agents