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Diagnosis of hepatitis C virus infection in Scotland's injecting drug user population

McDonald, S.A. and Hutchinson, S.J. and Mills, P.R. and Bird, S.M. and Robertson, C. and Dillon, J.F. and Springbett, A. and Goldberg, D.J. (2010) Diagnosis of hepatitis C virus infection in Scotland's injecting drug user population. Infection and Epidemiology, 138. pp. 393-402. ISSN 0950-2688

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Abstract

We estimated the extent of undiagnosed hepatitis C virus (HCV) infection in injecting drug users (IDUs) in Scotland. We used record-linkage to determine HCV diagnosis status for 41 062 current/former IDUs attending drug treatment and support services between 1 April 1995 and 31 March 2006; the extent of undiagnosed HCV infection was estimated by comparing the number HCV-diagnosed to the number HCV-infected (estimated from an unlinked anonymous testing survey of 2141 current/former IDUs). In all, 9145 IDUs (22%) were diagnosed HCV antibody-positive since first attendance at drug services (diagnosis rate of 33.6/1000 person-years,95% CI 32.7-34.4). By 31 March 2006, of the 19 632 current/former IDUs who had attended drug services and were determined to be living with HCV, an estimated 58% (95% CI 45-62)had not been HCV-diagnosed. It is essential that the deployment of resources for identifying at-risk IDUs with a view to offering antiviral therapy is guided by evidence.