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Multicenter Study
. 2009 Aug 1;170(3):352-60.
doi: 10.1093/aje/kwp141. Epub 2009 Jun 22.

Hepatitis C infection among injecting drug users in England and Wales (1992-2006): there and back again?

Michael J Sweeting  1 , Vivian D Hope, Matthew Hickman, John V Parry, Fortune Ncube, Mary E Ramsay, Daniela De Angelis
Affiliations
Multicenter Study

Hepatitis C infection among injecting drug users in England and Wales (1992-2006): there and back again?

Michael J Sweeting et al. Am J Epidemiol. .

Abstract

Changes in hepatitis C virus (HCV) prevalence from 1992 to 2006 were examined by using 24,311 records from unlinked anonymous surveillance of injecting drug users in England and Wales. Bayesian logistic regression was used to estimate annual prevalence, accounting for changing recruitment patterns (age, gender, injecting duration, geographic region, interactions) and the sensitivity and specificity of different oral fluid testing devices. After controlling for these differences, the authors found that the adjusted HCV prevalence decreased from 70% (95% credible interval: 62, 78) in 1992 to 47% (95% credible interval: 43, 51) in 1998 before rising again to 53% (95% credible interval: 48, 58) in 2006. Women injecting drug users had a higher HCV risk than did men (odds ratio = 1.50, 95% credible interval: 1.31, 1.73). Two regions (London and North West) had a markedly higher HCV prevalence than did the rest of England and Wales. Among individuals who had injected for less than 1 year, the adjusted HCV prevalence in 2006 was higher than that in 1992 (28% vs. 19%, respectively). HCV infection can be prevented. The public health challenge in England and Wales is to increase action in order to regain a downward trend in HCV risk and the benefit that has been lost since 1998.

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Figures

Figure 1.
Figure 1.
Estimated hepatitis C virus (HCV) antibody prevalence trend for injecting drug users before and after accounting for test device sensitivities and specificities, England and Wales, 1992–2006. All other covariates are set to their mean values. Dashed lines show 95% credible intervals for the model accounting for device misclassification. Dotted lines show 95% credible intervals for the model not accounting for device misclassification.
Figure 2.
Figure 2.
Estimated hepatitis C virus (HCV) antibody prevalence trend for injecting drug users by recent and nonrecent initiates, England and Wales, 1992–2006. All other covariates are set to their mean values. Error bars show 95% credible intervals.
Figure 3.
Figure 3.
Estimated hepatitis C virus (HCV) antibody prevalence trend for injecting drug users by region, England and Wales, 1992–2006. All other covariates are set to their mean values. Error bars show 95% credible intervals for each region.
See this image and copyright information in PMC

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