Risk Groups

Risk groups include homeless individuals, homosexuals, IDUs, travellers abroad who have not been vaccinated, patients with chronic liver disease and chronic infection with HBV and HCV, employees and residents in daycare centers and hostels, sewage workers, laboratory technicians, and those handling nonhuman primates.

Several large outbreaks have occurred among IDUs, some with an epi-demiological link to prisons (87,88). Transmission occurs during the viremic phase of the illness through sharing injecting equipment and via fecal-oral routes because of poor living conditions (89). There have also been reports of HAV being transmitted through drugs that have been carried in the rectum. A study in Vancouver showed that 40% of IDUs had past infection of HAV, and they also showed an increased prevalence among homosexual/bisuexual men (90).

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