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

Michael J. Sweeting, Vivian D. Hope, Matthew Hickman, John Parry, Fortune Ncube, Mary Ramsay, Daniela De Angelis

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47 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)352-360
Number of pages9
JournalAmerican Journal of Epidemiology
Issue number3
Publication statusPublished - Aug 2009


  • England
  • Hepatitis C
  • Prevalence
  • Sentinel surveillance
  • Substance abuse, intravenous
  • Wales


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