There are estimates that HBV has infected nearly 2 billion people worldwide, of whom 350 million have evidence of chronic infection which carries similar risks to those of HCV of complications such as cirrhosis and liver cancer (Kane, 1995). HBV is unique among the group of infectious diseases associated with IDU, as there has been an effective vaccine available for over two decades (Hutchinson et al, 2004). However, studies have shown that vaccine uptake has been very low among injection drug users, ranging from 4 percent to 29 percent vaccination (Seal et al, 2000). A recent study completed in New York City showed that factors associated with HBV vaccine completion included never having injected drugs (P < 0.02), and currently receiving public assistance (aOR 2.38; 95 percent CI, 1.24-4.56) (Ompad et al, 2004). A study completed in New Haven verified the aforementioned factors associated with success of vaccine completion. What's more, this study showed that using syringe exchange sites as opportunities to provide vaccination was associated with completion of administration of two doses of vaccine in 77 percent (103/134) and the full three doses in 66 percent (89/134) of vaccine-eligible users (Altice et al, 2005). As the WHO Expanded Program on Immunization added HBV in 1992, epidemiologists expect that incidence and prevalence will decrease in the next generation as a result of increased immunity (Ompad etal., 2004).

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