[Epidemiology of hepatitis C and human immunodeficiency virus infections among injecting drug users in Hungary--what's next?]

Abstract

The prevalence of hepatitis C virus infection (HCV) is currently about 35% among injecting drug users in Budapest, Hungary, and it is under 20% outside of the capital, and no verified case of human immunodeficiency virus (HIV) have been detected so far. Mathematical models describe that the co-occurrence of HIV and HCV among injecting drug users is such under an HCV prevalence of about 35% the probability of an HIV epidemic is low, but above this threshold an, HIV epidemic is to be expected. According to these models, there is a looming probability of an HIV epidemic among injecting drug users in Hungary, especially in Budapest. There are four ways to prevent or delay such an epidemic: 1. substitution treatment programs; 2. legal access to injecting equipment; 3. free and confidential HIV and HCV counseling and rapid testing; and 4. hygienic injecting environment. In order to avoid a predicted HIV epidemic, epidemiological pattern of HCV among injecting drug users in Hungary requires both a comprehensive prevention response and the systematic monitoring of the epidemiological situation. The success of the prevention programs depends on two factors: 1. wide access; and 2. regular financial support from the government.