Skip to main content
NCBI home page
American Journal of Public Health logoLink to American Journal of Public Health
. 2001 Jan;91(1):38–42. doi: 10.2105/ajph.91.1.38

Prevalence of hepatitis C among injection drug users in England and Wales: is harm reduction working?

V D Hope 1, A Judd 1, M Hickman 1, T Lamagni 1, G Hunter 1, G V Stimson 1, S Jones 1, L Donovan 1, J V Parry 1, O N Gill 1
PMCID: PMC1446497  PMID: 11189821

Abstract

OBJECTIVES: This study sought to establish the prevalence of hepatitis C antibodies (anti-HCV) and hepatitis B antibodies (anti-HBc) among injection drug users in England and Wales. METHODS: A voluntary cross-sectional survey collected oral fluid samples and behavioral information; 2203 injectors were recruited through drug agencies, and 758 were recruited in the community. RESULTS: Prevalence was 30% for anti-HCV, 21% for anti-HBc, and 0.9% for HIV antibodies. Anti-HCV prevalence rates were significantly greater among those with longer injecting careers, those in older age groups, those residing in London, those recruited in drug agencies, those positive for anti-HBc, and those with a previous voluntary HIV test. CONCLUSIONS: Anti-HCV prevalence rates among injectors in England and Wales, where comprehensive harm reduction programs exist, are lower than rates in other industrialized countries.

Full Text

The Full Text of this article is available as a PDF (84.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allwright S., Bradley F., Long J., Barry J., Thornton L., Parry J. V. Prevalence of antibodies to hepatitis B, hepatitis C, and HIV and risk factors in Irish prisoners: results of a national cross sectional survey. BMJ. 2000 Jul 8;321(7253):78–82. doi: 10.1136/bmj.321.7253.78. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Balogun M. A., Ramsay M. E., Fairley C. K., Collins M., Heptonstall J. Acute hepatitis B infection in England and Wales: 1985-96. Epidemiol Infect. 1999 Feb;122(1):125–131. doi: 10.1017/s0950268898001733. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Broers B., Junet C., Bourquin M., Déglon J. J., Perrin L., Hirschel B. Prevalence and incidence rate of HIV, hepatitis B and C among drug users on methadone maintenance treatment in Geneva between 1988 and 1995. AIDS. 1998 Oct 22;12(15):2059–2066. doi: 10.1097/00002030-199815000-00018. [DOI] [PubMed] [Google Scholar]
  4. Cameron S. O., Wilson K. S., Good T., McMenamin J., McCarron B., Pithie A., Fox R. Detection of antibodies against hepatitis C virus in saliva: a marker of viral replication. J Viral Hepat. 1999 Mar;6(2):141–144. doi: 10.1046/j.1365-2893.1999.00142.x. [DOI] [PubMed] [Google Scholar]
  5. Coppola R. C., Manconi P. E., Piro R., Di Martino M. L., Masia G. HCV, HIV, HBV and HDV infections in intravenous drug addicts. Eur J Epidemiol. 1994 Jun;10(3):279–283. doi: 10.1007/BF01719350. [DOI] [PubMed] [Google Scholar]
  6. Coutinho R. A. HIV and hepatitis C among injecting drug users. BMJ. 1998 Aug 15;317(7156):424–425. doi: 10.1136/bmj.317.7156.424. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Crofts N., Aitken C. K. Incidence of bloodborne virus infection and risk behaviours in a cohort of injecting drug users in Victoria, 1990-1995. Med J Aust. 1997 Jul 7;167(1):17–20. doi: 10.5694/j.1326-5377.1997.tb138757.x. [DOI] [PubMed] [Google Scholar]
  8. Crofts N., Nigro L., Oman K., Stevenson E., Sherman J. Methadone maintenance and hepatitis C virus infection among injecting drug users. Addiction. 1997 Aug;92(8):999–1005. [PubMed] [Google Scholar]
  9. Des Jarlais D. C., Hagan H., Friedman S. R., Friedmann P., Goldberg D., Frischer M., Green S., Tunving K., Ljungberg B., Wodak A. Maintaining low HIV seroprevalence in populations of injecting drug users. JAMA. 1995 Oct 18;274(15):1226–1231. doi: 10.1001/jama.274.15.1226. [DOI] [PubMed] [Google Scholar]
  10. Di Bisceglie A. M. Hepatitis C. Lancet. 1998 Jan 31;351(9099):351–355. doi: 10.1016/S0140-6736(97)07361-3. [DOI] [PubMed] [Google Scholar]
  11. Donahue J. G., Nelson K. E., Muñoz A., Vlahov D., Rennie L. L., Taylor E. L., Saah A. J., Cohn S., Odaka N. J., Farzadegan H. Antibody to hepatitis C virus among cardiac surgery patients, homosexual men, and intravenous drug users in Baltimore, Maryland. Am J Epidemiol. 1991 Nov 15;134(10):1206–1211. doi: 10.1093/oxfordjournals.aje.a116023. [DOI] [PubMed] [Google Scholar]
  12. Garfein R. S., Vlahov D., Galai N., Doherty M. C., Nelson K. E. Viral infections in short-term injection drug users: the prevalence of the hepatitis C, hepatitis B, human immunodeficiency, and human T-lymphotropic viruses. Am J Public Health. 1996 May;86(5):655–661. doi: 10.2105/ajph.86.5.655. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Goldberg D., Cameron S., McMenamin J. Hepatitis C virus antibody prevalence among injecting drug users in Glasgow has fallen but remains high. Commun Dis Public Health. 1998 Jun;1(2):95–97. [PubMed] [Google Scholar]
  14. Hagan H., Jarlais D. C., Friedman S. R., Purchase D., Alter M. J. Reduced risk of hepatitis B and hepatitis C among injection drug users in the Tacoma syringe exchange program. Am J Public Health. 1995 Nov;85(11):1531–1537. doi: 10.2105/ajph.85.11.1531. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Hagan H., McGough J. P., Thiede H., Weiss N. S., Hopkins S., Alexander E. R. Syringe exchange and risk of infection with hepatitis B and C viruses. Am J Epidemiol. 1999 Feb 1;149(3):203–213. doi: 10.1093/oxfordjournals.aje.a009792. [DOI] [PubMed] [Google Scholar]
  16. Hunter G. M., Stimson G. V., Judd A., Jones S., Hickman M. Measuring injecting risk behaviour in the second decade of harm reduction: a survey of injecting drug users in England. Addiction. 2000 Sep;95(9):1351–1361. doi: 10.1046/j.1360-0443.2000.95913516.x. [DOI] [PubMed] [Google Scholar]
  17. Hurley S. F., Jolley D. J., Kaldor J. M. Effectiveness of needle-exchange programmes for prevention of HIV infection. Lancet. 1997 Jun 21;349(9068):1797–1800. doi: 10.1016/S0140-6736(96)11380-5. [DOI] [PubMed] [Google Scholar]
  18. Judd A., Hunter G. M., Maconochie N., Hickman M., Parry J. V., Renton A. M., Stimson G. V. HIV prevalence and risk behaviour among female injecting drug users in London, 1990 to 1996. AIDS. 1999 May 7;13(7):833–837. doi: 10.1097/00002030-199905070-00013. [DOI] [PubMed] [Google Scholar]
  19. Lamden K. H., Kennedy N., Beeching N. J., Lowe D., Morrison C. L., Mallinson H., Mutton K. J., Syed Q. Hepatitis B and hepatitis C virus infections: risk factors among drug users in Northwest England. J Infect. 1998 Nov;37(3):260–269. doi: 10.1016/s0163-4453(98)92045-x. [DOI] [PubMed] [Google Scholar]
  20. MacDonald M., Crofts N., Kaldor J. Transmission of hepatitis C virus: rates, routes, and cofactors. Epidemiol Rev. 1996;18(2):137–148. doi: 10.1093/oxfordjournals.epirev.a017921. [DOI] [PubMed] [Google Scholar]
  21. Majid A., Holmes R., Desselberger U., Simmonds P., McKee T. A. Molecular epidemiology of hepatitis C virus infection amongst intravenous drug users in rural communities. J Med Virol. 1995 May;46(1):48–51. doi: 10.1002/jmv.1890460111. [DOI] [PubMed] [Google Scholar]
  22. Serfaty M. A., Lawrie A., Smith B., Brind A. M., Watson J. P., Gilvarry E., Bassendine M. F. Risk factors and medical follow-up of drug users tested for hepatitis C--can the risk of transmission be reduced? Drug Alcohol Rev. 1997 Dec;16(4):339–347. doi: 10.1080/09595239700186721. [DOI] [PubMed] [Google Scholar]
  23. Stimson G. V. Has the United Kingdom averted an epidemic of HIV-1 infection among drug injectors? Addiction. 1996 Aug;91(8):1085–1099. doi: 10.1046/j.1360-0443.1996.91810892.x. [DOI] [PubMed] [Google Scholar]
  24. Stimson G. V., Hunter G. M., Donoghoe M. C., Rhodes T., Parry J. V., Chalmers C. P. HIV-1 prevalence in community-wide samples of injecting drug users in London, 1990-1993. AIDS. 1996 Jun;10(6):657–666. doi: 10.1097/00002030-199606000-00012. [DOI] [PubMed] [Google Scholar]
  25. Stimson G. V., Jones S., Chalmers C., Sullivan D. A short questionnaire (IRQ) to assess injecting risk behaviour. Addiction. 1998 Mar;93(3):337–347. doi: 10.1046/j.1360-0443.1998.9333373.x. [DOI] [PubMed] [Google Scholar]
  26. Van Ameijden E. J., Van den Hoek J. A., Mientjes G. H., Coutinho R. A. A longitudinal study on the incidence and transmission patterns of HIV, HBV and HCV infection among drug users in Amsterdam. Eur J Epidemiol. 1993 May;9(3):255–262. doi: 10.1007/BF00146260. [DOI] [PubMed] [Google Scholar]
  27. Weild A. R., Gill O. N., Bennett D., Livingstone S. J., Parry J. V., Curran L. Prevalence of HIV, hepatitis B, and hepatitis C antibodies in prisoners in England and Wales: a national survey. Commun Dis Public Health. 2000 Jun;3(2):121–126. [PubMed] [Google Scholar]
  28. van Beek I., Buckley R., Stewart M., MacDonald M., Kaldor J. Risk factors for hepatitis C virus infection among injecting drug users in Sydney. Genitourin Med. 1994 Oct;70(5):321–324. doi: 10.1136/sti.70.5.321. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. van Beek I., Dwyer R., Dore G. J., Luo K., Kaldor J. M. Infection with HIV and hepatitis C virus among injecting drug users in a prevention setting: retrospective cohort study. BMJ. 1998 Aug 15;317(7156):433–437. doi: 10.1136/bmj.317.7156.433. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES