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Targets for Hepatitis C virus test uptake and case-finding among injecting drug users: in prisons and general practice

Bird, S.M. and Robertson, R. and Hutchinson, S.J. (2010) Targets for Hepatitis C virus test uptake and case-finding among injecting drug users: in prisons and general practice. Addiction Research and Theory, 18 (4). pp. 421-432. ISSN 1606-6359

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We re-analyse data on new diagnoses of Hepatitis C virus (HCV) for injectors in prison or attending general practices which were relied on for the cost-effectiveness of HCV testing in injectors. We use these revised estimates to suggest readily-achievable targets in Scottish general practices on HCV diagnoses for injectors born in 1956-75. Using audit data from general practices around Edinburgh, we confirm that, with effort, the suggested targets are achievable. On re-analysis, we found that over 20% of HCV-undiagnosed injectors in English prisons accepted HCV testing, and half the injectors aged 30-54 years who attended a Glasgow general practice. On the basis of 30% HCV test uptake and 80% of ever-injectors having self-identified, a target of 2,500 HCV diagnoses within a year in known ever-injectors born in 1956-75 attending Scottish general practices is feasible. Its target of five new HCV diagnoses was achieved during an HCV testing intervention by Muirhouse Practice, Edinburgh. During a 2-year audit period, 86 other general practices around Edinburgh providing enhanced services for drug users increased HCV test uptake by known ever-injectors from 43%% (314/727) to 62%% (655/1,062) in the 1956-75 birth-cohort. Their new HCV diagnoses in ever-injectors were 171 over two years against a target of 166 within 1 year.