Injecting drug users represent a high risk group of hepatitis C (HCV) infection. Currently screening of this group for HCV is inconsistently implemented. A HCV assessment algorithm was designed and used to determine the frequency with which injecting drug users completed the assessment process. The algorithm was piloted in the setting of a specialised outpatient addiction treatment clinic.

Participants consisted of consecutive new attenders over a six month period with a history of injecting. Only 21 (18%) of 119 patients reached a satisfactory endpoint of assessment. Forty-eight injectors were tested for antibody to HCV, of whom 26 (54%) tested positive. Thirteen of those with positive test results were no longer attending when the test result became available. Only 4 of the 19 patients who were referred, attended the on-site hepatology clinic. Thorough screening of injecting drug users for HCV within one treatment service is difficult. A need is identified for explicit policies on this issue involving co-operation between primary care providers and addiction services and hepatology services.