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Open Access research with a European policy impact...

The Strathprints institutional repository is a digital archive of University of Strathclyde's Open Access research outputs. Strathprints provides access to thousands of Open Access research papers by Strathclyde researchers, including by researchers from the European Policies Research Centre (EPRC).

EPRC is a leading institute in Europe for comparative research on public policy, with a particular focus on regional development policies. Spanning 30 European countries, EPRC research programmes have a strong emphasis on applied research and knowledge exchange, including the provision of policy advice to EU institutions and national and sub-national government authorities throughout Europe.

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Reconstructing the historical incidence of hepatitis C infection among Scotland's IDUS

McDonald, S. and Kretzschmar, M. and Hutchinson, S. and Goldberg, D. (2011) Reconstructing the historical incidence of hepatitis C infection among Scotland's IDUS. Journal of Epidemiology and Community Health, 65 (Supple). A271-A271. ISSN 0143-005X

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Abstract

The historical incidence of hepatitis C virus (HCV) infection in Scotland's injecting drug user (IDU) population is unknown. From a public health perspective, accurate data on incidence rates over time would improve our understanding of the effects of harm reduction measures initiated in the late 1980s (needle/syringe exchanges, methadone treatment) on the transmission of HCV among Scotland's IDUs. Because HCV-antibody testing only commenced in 1991, and positive diagnoses are often made many years after infection, trends in incidence cannot easily be inferred from trends in the time-series of diagnosed cases. We applied back-calculation methods to reconstruct HCV incidence using data available on the national HCV Diagnosis database (1991–2009; n=25 000), estimates from the literature regarding time to seroconversion and mortality rates, and the estimated distribution of time between injection debut and diagnosis, derived via record-linkage between the HCV Diagnosis and the Scottish Drugs Misuse databases. Approximately 50 000 IDUs were estimated to have been infected with HCV during 1960–2009. The shape of the incidence curve varied with region, but a peak in annual incidence was estimated to have occurred around 1993. The model projected approximately 1700 new HCV diagnoses per year over the coming 5 years. Sensitivity analyses were also conducted to explore assumptions regarding mortality rate and the proportion of infected IDUs that are never diagnosed. These incidence data are important for evaluation of the impact of harm reduction initiatives, for informing national public health planning, and for projecting the future burden of HCV-related severe liver disease.