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Prevalência de hepatite C, hepatite B e HIV e fatores de risco associados em utilizadores de substâncias que melhoram o desempenho: revisão sistemática da literatura
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Introdução: O uso de substâncias para melhorar o desempenho (PES), antes restrito a atletas, é hoje comum em utilizadores de ginásios, que frequentemente adotam comportamentos de risco, como a partilha e reutilização de material de injeção. Estas práticas aumentam o risco de propagação de infeções como hepatite C, B e VIH. É, por isso, essencial entender a prevalência destas infeções e os seus fatores de risco associados, para delinear estratégias de saúde pública eficazes e preencher as lacunas na literatura. Objetivos: O objetivo desta revisão sistemática foi sintetizar a evidência científica sobre a prevalência de VIH, VHB e VHC em utilizadores de PES e identificar os fatores de risco associados. Especificamente, procurou-se comparar a prevalência entre distintos grupos demográficos de utilizadores de PES e identificar os fatores de risco para estas infeções. Métodos: Foi realizada uma revisão sistemática da literatura, seguindo as diretrizes PRISMA. A pesquisa foi conduzida nas bases de dados Scopus, PubMed e Web of Science, utilizando o acrónimo PICOS para estruturar a questão de investigação. Foram incluídos 21 estudos em inglês, espanhol ou português, que avaliaram a prevalência e os fatores de risco para VIH, VHB e VHC em utilizadores de PES. Resultados: A prevalência das infeções variou consideravelmente entre os estudos. A prevalência de VIH, com base em diagnóstico laboratorial, situou-se entre 0% e 2,4%, embora estudos baseados em autorrelato em subpopulações de alto risco, como homens que fazem sexo com homens (HSH), tenham reportado valores muito mais elevados. A prevalência de VHB variou de 0,68% a 12%, e a de VHC de 0,68% a 9,5%. Os principais fatores de risco identificados foram a partilha de equipamento de injeção, o uso concomitante de drogas psicoativas injetáveis, comportamentos sexuais de risco e o histórico prisional. Verificou-se também uma baixa adesão a medidas preventivas, como a testagem para estas infeções e a vacinação contra o VHB. Conclusão: Os utilizadores de PES constituem uma população com risco acrescido para a transmissão de VIH, VHB e VHC, superior ao da população geral, embora geralmente inferior ao de utilizadores de drogas psicoativas. É fundamental implementar intervenções de educação, prevenção, testagem e vacinação adaptadas a este público específico, a fim de mitigar a trans-missão destas infeções.
ABSTRACT Introduction: The use of performance-enhancing substances (PES), once restricted to athletes, is now common among gym users, who often adopt risky behaviors, such as sharing and reusing injection equipment. These practices increase the risk of spreading infections like Hepatitis C, B, and HIV. It is, therefore, essential to understand the prevalence of these infections and their associated risk factors to design effective public health strategies and fill the gaps in the literature. Objectives: The objective of this systematic review was to synthesize the scientific evidence on the prevalence of HIV, HBV, and HCV in PES users and to identify the associated risk factors. Specifically, we sought to compare the prevalence among different demographic groups of PES users and to identify the risk factors for these infections. Methods: A systematic literature review was conducted, following the PRISMA guidelines. The search was performed in the Scopus, PubMed, and Web of Science databases, using the PICOS acronym to structure the research question. Twenty-one studies in English, Spanish, or Portuguese were included, which assessed the prevalence and risk factors for HIV, HBV, and HCV in PES users. Results: The prevalence of the infections varied considerably among the studies. The prevalence of HIV, based on laboratory diagnosis, ranged from 0% to 2.4%, although studies based on self-reporting in high-risk subpopulations, such as men who have sex with men (MSM), reported much higher values. The prevalence of HBV ranged from 0.68% to 12%, and that of HCV from 0.68% to 9.5%. The main risk factors identified were the sharing of injection equipment, the concomitant use of psychoactive injectable drugs, risky sexual behaviors, and a history of imprisonment. A low adherence to preventive measures, such as testing for these infections and vaccination against HBV, was also observed. Conclusion: PES users constitute a population at an increased risk for HIV, HBV, and HCV transmission, which is higher than that of the general population, although generally lower than that of psychoactive drug users. It is crucial to implement education, prevention, testing, and vaccination interventions tailored to this specific audience to mitigate the transmission of these infections.
ABSTRACT Introduction: The use of performance-enhancing substances (PES), once restricted to athletes, is now common among gym users, who often adopt risky behaviors, such as sharing and reusing injection equipment. These practices increase the risk of spreading infections like Hepatitis C, B, and HIV. It is, therefore, essential to understand the prevalence of these infections and their associated risk factors to design effective public health strategies and fill the gaps in the literature. Objectives: The objective of this systematic review was to synthesize the scientific evidence on the prevalence of HIV, HBV, and HCV in PES users and to identify the associated risk factors. Specifically, we sought to compare the prevalence among different demographic groups of PES users and to identify the risk factors for these infections. Methods: A systematic literature review was conducted, following the PRISMA guidelines. The search was performed in the Scopus, PubMed, and Web of Science databases, using the PICOS acronym to structure the research question. Twenty-one studies in English, Spanish, or Portuguese were included, which assessed the prevalence and risk factors for HIV, HBV, and HCV in PES users. Results: The prevalence of the infections varied considerably among the studies. The prevalence of HIV, based on laboratory diagnosis, ranged from 0% to 2.4%, although studies based on self-reporting in high-risk subpopulations, such as men who have sex with men (MSM), reported much higher values. The prevalence of HBV ranged from 0.68% to 12%, and that of HCV from 0.68% to 9.5%. The main risk factors identified were the sharing of injection equipment, the concomitant use of psychoactive injectable drugs, risky sexual behaviors, and a history of imprisonment. A low adherence to preventive measures, such as testing for these infections and vaccination against HBV, was also observed. Conclusion: PES users constitute a population at an increased risk for HIV, HBV, and HCV transmission, which is higher than that of the general population, although generally lower than that of psychoactive drug users. It is crucial to implement education, prevention, testing, and vaccination interventions tailored to this specific audience to mitigate the transmission of these infections.
Description
Keywords
Substâncias que melhoram o desempenho Hepatite C Hepatite B Infeção pelo VIH Fator de risco Prevalência Performance-enhancing substances Hepatitis C Hepatitis B HIV infection Risk factor Prevalence MTCL
Pedagogical Context
Citation
Ferreira JI. Prevalência de hepatite C, hepatite B e HIV e fatores de risco associados em utilizadores de substâncias que melhoram o desempenho: revisão sistemática da literatura [dissertation]. Lisboa: Escola Superior de Tecnologia da Saúde de Lisboa/Instituto Politécnico de Lisboa; 2025.