Hepatitis B and C Virus Infections Among Human Immunodeficiency Virus-Infected People Who Inject Drugs in Lahore, Pakistan Sana Mansha, 1 Muhammad Imran, 2 Amir Miraj Ul Hussain Shah, 2 Muhsin Jamal, 3 Fayyaz Ahmed, 2 Muhammad Atif, 2 Muhammmad Saleem, 2 Sher Zaman Safi, 4 Zareen Fatima, 5 and Ahmed Bilal Waqar 2 Abstract Hepatitis B virus (HBV) and hepatitis C virus (HCV) are the major cause of the global burden of hepatitis. One of the main routes of transmission for both viruses is through exposure to infected blood, which includes sharing blood-contaminated syringes and needles. Human immunodeficiency virus (HIV) attacks the immune system and results in acquired immune deficiency syndrome and opportunistic infections. The objective of this study was to assess the epidemiology of HBV and HCV infections among HIV-infected people who inject drugs (PWID). The study enrolled 100 PWID from different addiction centers of the city of Lahore in Pakistan. All subjects were HIV-infected males and were above 16 years of age. Screening of HBV and HCV infections was performed through immunochromatography tests and enzyme-linked immunosorbent assays. The prevalence of HCV and HBV infections among the 100 HIV-infected PWID was 55% and 6%, respectively. HIV mono- infection was found in 37% of the subjects, while triple infection was detected in 2% of the subjects. Majority of the HIV-infected PWID were using heroin and Avil injections (65%). Half of the subjects had used injection drugs for 1–5 years, while 32% had used injection drugs for 6–10 years. HCV infection was more common than HBV infection among the enrolled subjects. Most of the PWID were practicing heroin and Avil injections. Keywords: HCV, HBV, HIV, PWID, injection, infection Introduction V iral infections such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) are a global health burden. An estimated 2 billion people are HBV infected, while 200 million people are living with HCV infection in the world (4,12). Moreover, according to the current report of World Health Organization (WHO), 37 million people are HIV infected across the world (14). It is estimated that each year globally 1 million people die due to HBV infection, 350,000 deaths occur due to HCV infections, and 2 million people die due to HIV infection (6,9,17). Co- infection with HIV-HCV and HIV-HBV is common world- wide (3). It is reported that HIV-HCV coinfection among people who inject drugs (PWID) may surpass even 90% in some parts of the world (1,18). A recent report of WHO demonstrated that globally 2.3 million people are HIV and HCV coinfected. Additionally, more than half of HIV-HCV coinfected subjects, that is, 1.3 million, are PWID. It is also reported in the same study that HIV-monoinfected subjects are 6 times more likely than HIV-uninfected subjects to get HCV infection (23). Recent large-scale survey studies in Pakistan have dem- onstrated that the prevalence of HBV and HCV infections is 4.8% and 5%, respectively (2,13). HBV and HCV are the major reasons of hepatocellular carcinoma (HCC). Almost, 1 Department of Pathology, Allama Iqbal Medical College, Lahore, Pakistan. 2 Department of Medical Laboratory Sciences (DMLS), Faculty of Health and Allied Sciences (FHAS), Imperial College of Business Studies (ICBS), Lahore, Pakistan. 3 Department of Microbiology, Abdul Wali Khan University, Mardan, Pakistan. 4 Interdisciplinary Research Center in Biomedical Materials (IRCBM), COMSATS Institute of Information Technology, Lahore, Pakistan. 5 Department of Radiological Sciences and Medical Imaging (DRSMI), Faculty of Health and Allied Sciences (FHAS), Imperial College of Business Studies (ICBS), Lahore, Pakistan. VIRAL IMMUNOLOGY Volume 30, Number 5, 2017 ª Mary Ann Liebert, Inc. Pp. 1–5 DOI: 10.1089/vim.2016.0144 1