Skip to main content

Hepatitis C prevalence in injecting drug users in Europe, 1990–2007: impact of study recruitment setting

  • M. RONDY (a1) (a2), L. WIESSING (a3), S. J. HUTCHINSON (a4) (a5), C. MATHEÏ (a6), F. MATHIS (a7), V. MRAVCIK (a8), L. NORDEN (a9), M. ROSIŃSKA (a10), O. SCUTELNICIUC (a11), B. SULIGOI (a12), F. VALLEJO (a13), M. VAN VEEN (a1) and M. KRETZSCHMAR (a1) (a14)...

Monitoring injecting drug users' (IDUs) health is challenging because IDUs form a difficult to reach population. We examined the impact of recruitment setting on hepatitis C prevalence. Individual datasets from 12 studies were merged. Predictors of HCV positivity were sought through a multilevel analysis using a mixed-effects logistic model, with study identifier as random intercept. HCV prevalence ranged from 21% to 86% across the studies. Overall, HCV prevalence was higher in IDUs recruited in drug treatment centres compared to those recruited in low-threshold settings (74% and 42%, respectively, P < 0·001). Recruitment setting remained significantly associated with HCV prevalence after adjustment for duration of injecting and recent injection (adjusted odds ratio 0·7, 95% confidence interval 0·6–0·8, P = 0·05). Recruitment setting may have an impact on HCV prevalence estimates of IDUs in Europe. Assessing the impact of mixed recruitment strategies, including respondent-driven sampling, on HCV prevalence estimates, would be valuable.

Corresponding author
*Author for correspondence: Mr M. Rondy, 90 rue d'Amsterdam, 75011 Paris, France. (Email:
Hide All
1.Wiessing L, et al. Injecting drug use in Europe: stable or declining. Eurosurveillance 2010; 15: pii = 19604.
2.European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).Trends in injecting drug use in Europe. Selected Issue 2010. Lisbon: EMCDDA, 2010 ( Accessed 25 October 2011.
3.Friedland GH, et al. Intravenous drug abusers and the acquired immunodeficiency syndrome (AIDS) Demographic, drug use, and needle-sharing patterns. Archives of Internal Medicine 1985; 145: 14131417.
4.European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). 2010 Annual report on the state of the drugs problem in Europe. Lisbon, EMCDDA, 2010 ( Accessed 25 October 2011.
5.Roy K, et al. Monitoring hepatitis C virus infection among injecting drug users in the European Union: a review of the literature. Epidemiology and Infection 2002; 129: 577585.
6.Matheï C, Buntinx F, van Damme P. Seroprevalence of hepatitis C markers among intravenous drug users in western European countries: a systematic review. Journal of Viral Hepatitis 2002; 9: 157173.
7.WHO, UNODC & UNAIDS.Technical Guide for countries to set targets for Universal Access to HIV prevention, treatment and care for injecting drug users. WHO, UNODC & UNAIDS, 2009 ( Accessed 25 October 2011.
8.Wiessing L, et al. Associations between availability and coverage of HIV prevention measures and subsequent incidence of diagnosed HIV infection among injection drug users. American Journal of Public Health 2009; 99: 10491052.
9.Mathers BM, et al. for the 2009 Reference Group to the UN on HIV and Injecting Drug Use. HIV prevention, treatment, and care services for people who inject drugs: a systematic review of global, regional, and national coverage. Lancet 2010; 375: 10141028.
10.Rhodes T, Hedrich D (eds). Harm reduction: evidence, impacts and challenges. Lisbon: EMCDDA, 2010 ( Accessed 25 October 2011.
11.European Centre for Disease Prevention and Control and European Monitoring Centre for Drugs and Drug Addiction.Prevention and control of infectious diseases among people who inject drugs. Stockholm: ECDC, 2011 ( Accessed 25 October 2011.
12.European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).Guidelines for testing HIV, viral hepatitis and other infections in injecting drug users. EMCDDA Manuals, Lisbon, 2010 ( Accessed 25 October 2011.
13.Hedrich D, Pirona A, Wiessing L.From margin to mainstream: the evolution of harm reduction responses to problem drug use in Europe. Drugs Education Prevention and Policy 2008; 15: 503517.
14.European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Responses to drug use: harm reduction low-threshold service ( Accessed 25 October 2011.
15.Zabransky T, et al. Hepatitis C virus infection among injecting drug users in the Czech Republic – prevalence and associated factors. European Addiction Research 2006; 12: 151160.
16.Mravčík V, Šebákova H.HBV and HCV seroprevalence in injection drug users in Karvina District, Czech Republic [in Czech]. Adiktologie 2002; 2: 1927.
17.Camoni L, et al. , SerT Study Group.Continued high prevalence of HIV, HBV and HCV among injecting and noninjecting drug users in Italy. Annali dell'Istituto Superiore di Sanità 2010; 46: 5965.
18.Camoni L, et al. , SerT Study Group.Prevalence and correlates of infection with human immunodeficiency virus, hepatitis B virus, and hepatitis C virus among drug users in Italy: a cross-sectional study. Scandinavian Journal of Infectious Diseases 2009; 41: 521523.
19.Scutelniciuc O, et al. Behavioral and seroprevalence study Moldova 2007, Report. Chisinau, 2010, Tipografia Centrala.
20.Taylor A, et al. Prevalence of hepatitis C virus infection among injecting drug users in Glasgow 1990–1996: are current harm reduction strategies working? Journal of Infection 2000; 40: 176183.
21.Hutchinson SJ, et al. Factors associated with injecting risk behaviour among serial community-wide samples of injecting drug users in Glasgow 1990–94: implications for control and prevention of blood-borne viruses. Addiction 2000; 95: 931–40.
22.Taylor A, et al. Low and stable prevalence of HIV among drug injectors in Glasgow. International Journal of STD & AIDS 1994; 5: 105107.
23.Greenfield SF, et al. Substance abuse treatment entry, retention, and outcome in women: a review of the literature. Drug and Alcohol Dependence 2007; 86: 121.
24.Schechter MT, et al. Do needle exchange programmes increase the spread of HIV among injection drug users?: an investigation of the Vancouver outbreak. AIDS 1999; 13: F4551.
25.Platt L, et al. Measuring risk of HIV and HCV among injecting drug users in the Russian Federation. European Journal of Public Health 2009; 19: 428433.
26.Alter MJ. Epidemiology of hepatitis C virus infection. World Journal of Gastroenterology 2007; 13: 24362441.
27.Gerberding JL. Management of occupational exposures to blood-borne viruses. New England Journal of Medicine 1995; 332: 444451.
28.Lindenburg CE, et al. Decline in HIV incidence and injecting, but not in sexual risk behaviour, seen in drug users in Amsterdam: a 19-year prospective cohort study. AIDS 2006; 20: 17711775.
29.Hagan H, Des Jarlais DC. HIV and HCV infection among injecting drug users. Mount Sinai Journal of Medicine 2000; 67: 423428.
30.Hagan H, et al. Sharing of drug preparation equipment as a risk factor for hepatitis C. American Journal of Public Health 2001; 91: 4246.
31.European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). An overview of the drug-related infectious diseases (DRID) key indicator, Lisbon, January 2009 ( Accessed 25 October 2011.
32.Abdul-Quader AS, et al. Effectiveness of respondent-driven sampling for recruiting drug users in New York City: findings from a pilot study. Journal of Urban Health 2006; 83: 459476.
33.Heckathorn, Douglas D. Respondent-driven sampling: a new approach to the study of hidden populations. Social Problems 1997; 44: 174199.
34.Malekinejad M, et al. Accessing a diverse sample of injection drug users in San Francisco through respondent-driven sampling. Drug and Alcohol Dependence 2011; 118: 8391.
35.Uusküla A, et al. Evaluating recruitment among female sex workers and injecting drug users at risk for HIV using respondent-driven sampling in Estonia. Journal of Urban Health 2010; 87: 304317.
36.Rudolph AE, et al. Subpopulations of illicit drug users reached by targeted street outreach and respondent-driven sampling strategies: implications for research and public health practice. Annals of Epidemiology 2011; 21: 280289.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 1
Total number of PDF views: 8 *
Loading metrics...

Abstract views

Total abstract views: 135 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 25th November 2017. This data will be updated every 24 hours.