The prevalence of hepatitis C and related risk factors in drug users were compared in two geographic regions in Belgium, the city of Antwerp and the mixed urban–rural area of Limburg. All 310 participants were surveyed and screened for hepatitis B, hepatitis C and HIV. Prevalence rates of anti-HCV, anti-HBc and anti-HIV were 71, 62 and 4% in Antwerp and 46, 21 and 0% in Limburg respectively. Injecting drug use, duration of injecting drug use, work as a commercial sex-worker, originating from Turkey or Northern Africa, marginalization and anti-HBc positivity were identified as independent predictors for hepatitis C infection. In this study an important difference in HCV seroprevalence among drug users in a methadone maintenance programme across two geographic regions in Belgium was demonstrated. This was explained not only by variations in drug-related risk behaviour, but also by differences in sexual risk behaviour and socio-economic status.
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