Home > Update on blood-borne viral infections in injecting drug users.

Long, Jean (2011) Update on blood-borne viral infections in injecting drug users. Drugnet Ireland , Issue 37, Spring 2011 , pp. 19-21.

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HIV surveillance in 2009
Voluntary linked testing for antibodies to HIV has been available in Ireland since 1985. According to the most recent report of the Health Protection Surveillance Centre (HPSC),1 at the end of 2009 there were 5,369 diagnosed HIV cases in Ireland, of which 1,447 (27%) were probably infected through injecting drug use.  

Figure 1 presents the number of new cases of HIV among injecting drug users reported in Ireland, by year of diagnosis; data from 1982 to 1985 were excluded from the figure as these four years were combined in the source records.There was a fall in the number of HIV cases among injecting drug users between 1994 and 1998, with about 20 cases per year, compared to about 50 cases each year in the preceding years. There was a sharp increase in the number of cases in 1999 (69 new cases), which continued into 2000 (83 new cases). Between 2001 and 2009 there was an overall decline in the number of new injector cases (38, 50, 49, 71, 66, 57, 54, 36 and 30 respectively) when compared to 2000. It was difficult to interpret the trend owing to the relatively small numbers diagnosed each year, so a smoother curve (red plot line in Figure 1) was calculated using a rolling centred three-year average. This curve presents a new baseline of between 40 and 60 cases each year since 2006 and a declining trend.
 
Of the 30 new HIV cases among injecting drug users reported to the HPSC in 2009, 24 were male and six were female, and the average age was 36 years (range 22–57). Nineteen of the 30 cases with a known address lived in Dublin, Kildare or Wicklow.


Hepatitis B surveillance in 2009
Hepatitis B is a vaccine-preventable disease which is transmitted through contact with the blood or body fluids of an infected person. The main routes of transmission are mother-to-baby, child-to-child, sexual contact and unsafe injections. The number of cases notified to the HPSC increased in 2007 and 2008, but decreased by 12% in 2009, when it fell from 931 to 820. Of the 820 cases in 2009, 647 had a chronic infection, 78 had an acute infection and the disease status of 95 cases was unknown. The surveillance system has recorded risk factor data since 2004. The percentage of cases notified to the HPSC that included data on risk factors fell from 60% in 2008 to 44% (358 cases) in 2009 (Table 1). Of these 358 cases, ten (2.8%) reported injecting drug use as their main risk factor. The number of cases who reported injecting drug use remained consistently low between 2005 and 2009, indicating the effectiveness of routine administration of the hepatitis B vaccine to such cases.

Hepatitis C surveillance in 2009
Hepatitis C is one the most common blood-borne viral infections among injecting drug users and is transmitted through contact with the blood of an infected person. The main routes of transmission are mother-to-baby, unsafe injections, transfusion of blood and blood products, and unsterile tattooing and skin piercing. There were 1,255 cases of hepatitis C reported to the HPSC in 2009 (Table 2), compared to 1,527 cases in 2008.

An enhanced surveillance system for hepatitis C was introduced in Ireland in 2007. Enhanced surveillance is essential to identify risk factors and for planning prevention and treatment strategies. In 2009, 40% of newly reported hepatitis C cases had risk factor status reported (Table 3). As expected, the majority of these cases (70.9%) reported injecting drug use as the main risk factor. Four per cent of cases said that they had been recipients of blood or blood products at some time in the past and, according to the HPSC, were late reports to the system (N Murphy, HPSC, personal communication, 2009).

In 2009, 83% of cases reporting injecting drug use as their main risk factor were notified by services in Dublin, Kildare and Wicklow (Table 4). Seventy-three per cent were male and 62% were under 35 years old.

 

1. Jackson S, O'Donnell K, Moran J and O'Hora A (2010) HIV & AIDS in Ireland 2009. Dublin: Health Protection Surveillance Centre. 

Item Type:Article
Issue Title:Issue 37, Spring 2011
Date:2011
Page Range:pp. 19-21
Publisher:Health Research Board
Volume:Issue 37, Spring 2011
EndNote:View
Accession Number:HRB (Available)
Subjects:G Health and disease > Pathologic process > Inflammation or infection
G Health and disease > Disorder by cause > Communicable disease
G Health and disease > Disorder by cause > Communicable disease > Viral disease
J Health care, prevention and rehabilitation > Health related prevention > Health information and education > Communicable disease control
T Demographic characteristics > Intravenous / injecting drug user
VA Geographic area > Europe > Ireland

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