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Drugnet Europe News from the European Monitoring Centre for Drugs and Drug Addiction — January–March 2010

Hepatitis C prevalence as a possible indicator of injection-related HIV risk

A group of modellers and epidemiologists brought together by the EMCDDA has examined the potential for using information on the prevalence of the hepatitis C virus (HCV) among injecting drug users (IDUs) as an indicator of HIV transmission risk (1). HCV is transmitted via needle sharing in similar ways to HIV. As HCV is much more infectious, it might reveal the overall level of risk behaviour (e.g. needle sharing) in populations of IDUs where HIV has not yet spread. The findings are presented in a recent article published in Addiction.

As the article shows, data from different IDU populations (2) reveal a strong relationship between the prevalence of HIV and HCV, although the relationship is not always linear. At low HCV prevalence rates (< 30 %), for example, the HIV prevalence is likely to be near zero and unlikely to increase greatly, even if HCV prevalence is increasing. However, at higher HCV prevalence rates, the average HIV prevalence is greater, and the potential for an increase in HIV prevalence larger, especially with rises in HCV prevalence.

Despite variability in individual observations, these analyses suggest that the potential for an IDU HIV epidemic is greater in settings with high HCV prevalence. They also suggest that HCV prevalence can be viewed as a population-level marker of injection-related HIV risk, especially when HCV prevalence is rising. Given the above, keeping HCV prevalence among IDUs to under 30 % could be adopted as a target to minimise the risk of future increases in HIV prevalence or of HIV outbreaks.

(1) Vickerman, P., Hickman, M., May, M., Kretzschmar, M., and Wiessing, L., (2010) ‘Can hepatitis C virus prevalence be used as a measure of injection-related human immunodeficiency virus risk in populations of injecting drug users? An ecological analysis’, Addiction, Volume 105, Issue 2, pp. 311–318.

(2) Countries excluding Sub-Saharan Africa and South America.

Drugnet Europe is the EMCDDA's newsletter launched in September 1996. The newsletter provides regular and succint information on the Centre's projects and activities to a broad readership.

Page last updated: Thursday, 11 March 2010