Epidemiology

HIV and HCV infection rates higher than expected in London drug users

Last Updated: 2004-11-11 19:01:03 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Due possibly to harm reduction strategies implemented in the late 1980s, England had some of the lowest rates of HIV and hepatitis C virus (HCV) infection among injecting drug users (IDUs) during the 1990s. Now, new research suggests that these historically low rates have disappeared.

As reported in the November 11th online issue of the British Medical Journal, Dr. Ali Judd, from Imperial College London, and colleagues evaluated the prevalence of HIV and HCV infection among IDUs in 2001 by surveying and testing blood samples from 428 subjects. The subjects were younger than 30 years, had been injecting drugs for no more than 6 years, and had come mainly from London.

The prevalence of HCV and HIV infection at baseline was 43.7% and 4.2%, respectively. During 1-year follow-up, 53 patients became infected with HCV and 9 with HIV, yielding incidence rates of 41.8 and 3.4 cases per 100 person years, respectively.

The results suggest that rates of HCV and HIV infection are increasing among IDUs in England, the researchers note.

"Possible explanations for the rising incidence include changes in patterns of injecting drug use, with greater injection of crack and injecting risk behavior in newer IDUs than in those injecting in the early to mid-1990s," the authors state.

"Innovative strategies are required, specific to hepatitis C virus and to HIV, to change behavior and to deliver health education messages and harm reduction strategies early enough to make a difference," they add.

BMJ 2004.