{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T23:19:14Z","timestamp":1768259954369,"version":"3.49.0"},"reference-count":32,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T00:00:00Z","timestamp":1713398400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005564","name":"Gilead Sciences Inc.","doi-asserted-by":"publisher","award":["IN-US-980-6671"],"award-info":[{"award-number":["IN-US-980-6671"]}],"id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>The prevalence of hepatitis B and delta viruses (HBV\/HDV) among people who use drugs (PWUD) remains largely unknown. In the context of one Philadelphia-based harm reduction organization (HRO), this study aimed to assess HBV\/HDV prevalence and facilitate linkage to care. Participants completed a demographic HBV\/HDV risk factor survey and were screened for HBV and reflexively for HDV if positive for HBV surface antigen or isolated core antibody. Fisher\u2019s exact tests and regression were used to understand relationships between risks and HBV blood markers. Of the 498 participants, 126 (25.3%) did not have hepatitis B immunity, 52.6% had been vaccinated against HBV, and 17.9% had recovered from a past infection. Eleven (2.2%) participants tested positive for isolated HBV core antibody, 10 (2.0%) for HBV surface antigen, and one (0.2%) for HDV antibody. History of incarceration was associated with current HBV infection, while transactional sex and experience of homelessness were predictive of previous exposure. This study found high rates of current and past HBV infection, and a 10% HBV\/HDV co-infection rate. Despite availability of vaccine, one quarter of participants remained vulnerable to infection. Findings demonstrate the need to improve low-threshold HBV\/HDV screening, vaccination, and linkage to care among PWUD. The study also identified gaps in the HBV\/HDV care cascade, including lack of point-of-care diagnostics and lack of support for HROs to provide HBV services.<\/jats:p>","DOI":"10.3390\/v16040628","type":"journal-article","created":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T10:30:52Z","timestamp":1713436252000},"page":"628","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Dismantling Barriers to Hepatitis B and Delta Screening, Prevention, and Linkage to Care among the PWUD Community in Philadelphia"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2607-7506","authenticated-orcid":false,"given":"Beatrice","family":"Zovich","sequence":"first","affiliation":[{"name":"Hepatitis B Foundation, Doylestown, PA 18902, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1876-2105","authenticated-orcid":false,"given":"Catherine","family":"Freeland","sequence":"additional","affiliation":[{"name":"Hepatitis B Foundation, Doylestown, PA 18902, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holly","family":"Moore","sequence":"additional","affiliation":[{"name":"Hepatitis B Foundation, Doylestown, PA 18902, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8101-5963","authenticated-orcid":false,"given":"Kara","family":"Sapp","sequence":"additional","affiliation":[{"name":"Hepatitis B Foundation, Doylestown, PA 18902, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anousha","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Hepatitis B Foundation, Doylestown, PA 18902, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Holbert","sequence":"additional","affiliation":[{"name":"HepTREC at Prevention Point Philadelphia, Philadelphia, PA 19134, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Zambrano","sequence":"additional","affiliation":[{"name":"Hepatitis B Foundation, Doylestown, PA 18902, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daljinder","family":"Bhangoo","sequence":"additional","affiliation":[{"name":"Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA 19107, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1968-2104","authenticated-orcid":false,"given":"Chari","family":"Cohen","sequence":"additional","affiliation":[{"name":"Hepatitis B Foundation, Doylestown, PA 18902, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9545-4800","authenticated-orcid":false,"given":"Richard W.","family":"Hass","sequence":"additional","affiliation":[{"name":"Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA 19107, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1493-5021","authenticated-orcid":false,"given":"Amy","family":"Jessop","sequence":"additional","affiliation":[{"name":"HepTREC at Prevention Point Philadelphia, Philadelphia, PA 19134, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"153","DOI":"10.5588\/pha.18.0093-ed","article-title":"Public health interventions for reducing HIV, hepatitis B and hepatitis C infections in people who inject drugs","volume":"8","author":"Richardson","year":"2018","journal-title":"Public Health Action"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1833","DOI":"10.1007\/s10461-018-2293-0","article-title":"Factors associated with awareness of pre-exposure prophylaxis for HIV among persons who inject drugs in Philadelphia: National HIV behavioral surveillance, 2015","volume":"23","author":"Roth","year":"2019","journal-title":"AIDS Behav."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2053","DOI":"10.1016\/S0140-6736(14)60220-8","article-title":"Hepatitis B virus infection","volume":"384","author":"Chan","year":"2014","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1080\/10550887.2020.1771235","article-title":"Factors associated with HIV testing among people who inject drugs: A meta-analysis","volume":"38","author":"Bayani","year":"2020","journal-title":"J. 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