Statistical Table 16: Prevalence of hepatitis C infection (%) among injecting drug users in the EU (sample sizes in brackets)

Transcription

1 Statistical Table 6: Prevalence of hepatitis C infection (%) among injecting drug users in the EU (sample sizes in brackets) HCV - total Belgium, French Community - National Belgium, French Community - Namur / 46.9 (5) 38.5 (26) 5.7 (240) 5.3 (95) 52.0 (27) SR centres; selfreported test results; > 80% missing data. Prison; screening saliva. 9 Belgium, French Community - Lantin 28.2 (692) 24.8 (74) 27.7 (603) Prison; screening IDU status unknown prevalence may be too low. 6 Belgium, Flemish Community 2.8 (n.a.) 7.4 (32) Prisons; screening IDU status unknown prevalence may be too low. 7 Belgium, Flemish Community 39.5 (4) 46.4 (56) 37.9 (95) 36.0 (64) 35.8 (20) 2

2 Belgium, Flemish Community - Antwerp / 79.8 (252) centres, low threshold services; screening 8 Belgium, French Community - Charleroi 82.0 (8) 78.0 (244) General practitioners; screening 0 Belgium, Flemish Community (69) (2840), low-threshold and hospitals. 50% missing data. 3

3 / Denmark, Funen 85 (338) Prison, drug treatment centres; screening Denmark, Copenhagen 75 (264) 2

4 Germany, Frankfurt / 88.9 (90) 95.0 (60) 96.8 (63) 93.3 (75) 90.3 (72)?? Low threshold service. 2 Germany, Munich 6.9 (8) 67.3 (7) 65.7 (40) Inpatient treatment. 4 Germany, Lohr 65.8 (20) Inpatient treatment. Data Germany, Hamburg 86.0 (7) Inpatient treatment. 6 Germany, Hamburg 77 (6202)?? Prisons; screening 8 Germany, Berlin 82.5 (54)?? Syringe exchange in 2 prisons. Data Germany, Region? 74.7 (24)?? Prison. Data

5 / Germany, Berlin 84.0 (575)?? centres. Data Germany, Berlin 82.3 (405)?? Storefront agencies, CIA, hospital for Infectious Diseases. Data Germany, Frankfurt 78.5 (93)?? centres. Data Germany, Hamburg 40.0 (3)?? Laboratory. 3 Germany, Berlin 37.0 (86)?? Prison. 4 Germany, Wolfenbuttel 80.0 (84)?? Prison. 5

6 Germany, Berlin / 86.0 (279)?? centres. 6

7 Greece, Northern Region / 80.5 (297) Greece, Athens 49.6 (409) 8.6 (74) 4.2 (393) 82.9 (4) 42.8 (650) Methadone, drug treatment centres; screening Data 997 is Public health laboratories; screening 5 6 Greece, National 6.3 (253) 63. (30) Prisons; screening, 0 Greece, National 5.7 (286) 40. (439) 37.9 (398) 2 Greece, National 27.3 (57) 24.0 (577) 22.0 (729) centres, selfreported test results. 2 Greece, National 44.0 (637) centres; selfreported test results.

8 / Greece, Athens 68.0 (693) Methadone 7 treatment, screening Data Greece, Athens 56.2 (37) 46.3 (28) STD clinics; screening 8 Greece, National 52 (3) 80.9 (3) serum, 9 Greece, Athens 25.7 (35) Prisons; selfreported test results. Greece, National 67.9 (094) centres, low threshold services, public health laboratories, STD clinics; screening Greece, Thesaloniki 68.5 (54) Prison; screening 4

9 Greece, Athens & Patras / 80.5 (365) Prison; screening serum; data Greece, Athens 82.6 (75) centre; screening serum; data 990 and Greece, Patras 77.4 (06) Prison; screening 3 Spain, National excl. Galicia 83.2 (993) Survey of drug treatment centres. 3 Spain, 49.3 (233) centres, first and tertiary care centres. 8 Spain, SR (228) Street recruited 25 study; self-reported test results; IDUs not in treatment last 3 months.

10 Spain, El Prat de Llobregat (Barcelona) / 7. (355), hospital; screening serum; data Spain, Seville 92.0 (789)?? centres. 20 Spain, Valencia 8,2 (289)?? Aids Prevention Centre. 5 Spain, Valencia? 94.5 (275)?? Prison. Data 99 and Spain, Region? 75.3 (93)?? Data type? Data 990 and Spain, Cantabria 9.7 (362)?? Prison. Data

11 Spain, Region? / 84.4 (2555)?? Aids Centre. Data Spain, Valencia 85.5 (056)?? Screening serum, IDU-Center the Information and Prevention of AIDS. Data Spain, Gran Canaria 87.6 (2)?? Screening serum hospital. Data 993 and Spain, Madrid Barcelona Sevilla 75.9 (2) Screening Data extracted from clinic history of patients. drug treatment ambulatory. 3 Spain, Valencia 8.2 (356)?? Screening serum (CI95% : ) Center the Information and Pevention of AIDS. 4 Spain, North East 89.0 (495)?? Prison. 7

12 Spain, Majorca / 86.0 (95)?? centres. 8 Spain, Badalona 68.0 (4)?? Setting? 9 Spain, Barcelona 66.0 (25)?? Hospital outpatients. 2 Spain, Cantabria 85.0 (26)?? Prison. 22 Spain, Barcelona 66.0 (227)?? 2 Hospitals; screening Data IDUs who started injecting after

13 / France, 5 53 (n.a.) (n.a.) France, National (n.a.) (756) 59.5 (84) 63. (7930) SR SR centres; selfreported test results; sample sizes around Needle exchanges; 3 self-reported test results. France, Bordeaux Cayenne Dijon Fort-de France Lille Lyon Marseille Paris Renne La Reunion Toulouse France, Grasse Argentan 53.2 (98) 54.6 (339) SR Needle exchanges, low threshold services; selfreported test results.?? Marseille 996/97: 3 prisons, saliva. 4 5 France, Lille 80. (24)?? Prison. Data 995 and France, Strasbourg 67.0 (29)?? Laboratory.

14 France, Lille / 72. (04)?? centres; data 99 and France, Region? 9.0 (90)?? Prison. 8 France, Aquitane 90.0 (63)?? Hospital outpatients. 9 France, Moselle 63.0 (205)?? centres. 0 France, Toulouse 76 (246) SR centers, low threshold service, prisons, arrests, GPs; self-reported test results. 35.% unknown status. 4

15 Ireland, Dublin Ireland, National / (60) (77) (52) (8) (6) 8.3 (509) centre Trinity Court, first attendees ; ever- IDUs; Prison inmates; screening saliva (test sensitivity 80%, 95%CI )., 7 4 Ireland, National 7.7 (73) Prison entrants; screening saliva (test sensitivity 80%, 95%CI ). 2 Ireland, Eastern Regional Health Authority Ireland, Dublin Ireland, Dublin 84.2 (272) 78.8 (99) 72.6 (372) Survey GPs: 5 methadone clients, laboratory reports or clinical notes; 3.6% (78/57) non-idus, 35% (99/57) missing HCV status. Five drug treatment 6 centers: methadone clients, laboratory reports or clinical notes; serum; may include non- 2 centre Trinity Court; screening

16 / (659) (72336) (7352) (7477) (79096) serum; 5-0% non- Calabria Campania Emilia-Romagna Friuli Lazio Liguria Marche Piemonte Puglia Sardegna Sicilia Toscana Piemonte 68.8 (7402) 76.3 (6560) 67.7 (7050) 76.3 (6949) 76.3 (5998) centres; sample study in 2 regions; data are for ; screening serum; 5-0% non- 3 Piemonte 82.4 (833) Valle d Aosta 86.9 (76) 43.0 (42) 3.2 (68) 36.7 (60) centres; sample study in 2 regions; data are for ; screening serum; 5-0% non- 3 Lombardia (5064) (540) (4965) (533) serum; 5-0% non-

17 / Trentino 82.9 (742) 87.2 (782) 89.7 (005) 85.7 (677) serum; 5-0% non- Trento 85.2 (508) 86.7 (525) 84.3 (529) serum; 5-0% non- Bolzano 90.9 (274) 92.9 (480) 90.5 (48) serum; 5-0% non- Veneto 69.5 (4797) 72.5 (5355) 64.3 (395) 68.6 (4465) serum; 5-0% non- Friuli 79.9 (295) 77.8 (295) 77.5 (403) 75.9 (474) serum; 5-0% non- Friuli 80.6 (20) centres; sample study in 2 regions; data are for ; screening 3

18 Liguria / 77.4 (586) 84.9 (664) 77.7 (696) 67. (3422) serum; 5-0% non- Liguria Emilia Romagna 79.8 (4968) 66.3 (78) 82. (5333) 85.7 (559) 85.2 (526) centres; sample study in 2 regions; data are for ; screening serum; 5-0% non- 3 Emilia Romagna Toscana 73.5 (4600) 89.7 (340) 70.3 (4802) 63.7 (5544) 68.4 (509) centres; sample study in 2 regions; data are for ; screening serum; 5-0% non- 3 Toscana 6.5 (494) centres; sample study in 2 regions; data are for ; screening 3

19 Umbria / 75.8 (354) 64.0 (902) 62.4 (975) 52. (030) serum; 5-0% non- Marche 65.4 (82) 67.8 (87) 69.9 (297) 65.3 (508) serum; 5-0% non- Marche Lazio 65.2 (487) 72.8 (279) 65.0 (4250) 65.5 (4054) 65.4 (4000) centres; sample study in 2 regions; data are for ; screening serum; 5-0% non- 3 Lazio Abruzzo 54.0 (669) 78. (955) 50.6 (329) 50.5 (662) 48.4 (2328) centres; sample study in 2 regions; data are for ; screening serum; 5-0% non- 3

20 Molise / 69.2 (295) 66.5 (39) 70.7 (266) 59.9 (207) serum; 5-0% non- Campania 50.3 (707) 42.3 (8044) 46.3 (8354) 46. (942) serum; 5-0% non- Campania 58.0 (436) Puglia 60.3 (7939) 63.8 (6494) 63.2 (7202) 62.9 (674) centres; sample study in 2 regions; data are for ; screening serum; 5-0% non- 3 Puglia Basilicata 66.0 (456) 69.2 (72) 67.4 (488) 77.6 (424) 64.5 (54) centres; sample study in 2 regions; data are for ; screening serum; 5-0% non- 3

21 / Calabria 58.6 (240) 6.2 (82) 56. (724) 54.6 (27) serum; 5-0% non- Calabria Sicilia 65.0 (3557) 89.7 (340) 60.9 (382) 63.9 (460) 6.9 (5086) centres; sample study in 2 regions; data are for ; screening serum; 5-0% non- 3 Sicilia Sardegna 72.0 (2539) 73.5 (669) 83.2 (2349) 83. (2608) 78.0 (2543) centres; sample study in 2 regions; data are for ; screening serum; 5-0% non- 3 Sardegna 86.6 (738) centres; sample study in 2 regions; data are for ; screening 3

22 Brescia- Mombello Monza Milano-Opera / 64.2 (65) 3 prisons, screening saliva. 7 Cagliari Sardegna 8.0 (37) centres. Data 992 and Naples Campania 63. (73) centres. Data Bassano Veneto 75.3 (227) centres. Data Reggio Emilia Emilia Romagna 70.9 (508) centres, AIDS-Unit, Dpt of Infectious Diseases. Cagliari Sardegna 8.2 (255) centres. 2 Parma Emilia Romagna 8.2 (282) Prison. Data

23 Naples Campania / 59.4 (63) Institute of Social medicine and Public Security, Hospital of Infectious Diseases. (Data ) 5 Catanzaro Calabria 67.8 (46) centres. 6 Rome Lazio 63.4 (645) centres. Data Perugia Umbria 72 (350) Hospital outpatients. (Data ) Rome 50 (50) Prison. 24

24 / Luxembourg, 22. (23) 24.5 (249) 30.4 (247) 40.4 (337) SR centres, low threshold services, hospitals and police; self-reported test results., 3 Luxembourg, National 37.0 (6) Prison study; screening saliva. 4

25 / Netherlands, 73.3 (288) centres, needle exchanges, low threshold services; screening Netherlands, The Hague 47.2 (99) centres, needle exchanges, low threshold services; screening 9 Netherlands, Rotterdam 84.2 (322) centers, methadone post and street; screening saliva. 7 Netherlands, Arnhem 66.3 (80) Methadone care, low threshold services, street and street prostitution; screening saliva. 8

26 / Austria, Vienna 79.0 (9) 64.0 (92) 6.0 (88) 47.7 (07) Needle exchanges, low threshold services; screening 3 Austria, Vienna Lower Austria 85.0 (79) 73.0 (99) 74.0 (07) 72.0 (68) 7.0 (65) 4 Austria, Vorarlberg 72.2 (8) 56.8 (37) 40.7 (27) 58.3 (48) 69.0 (29) 48.0 (25) 67.6 (34) 2

27 National / 55.7 (n.a.) 48.8 (5765) 44.7 (2603) centres; IDU status unknown prevalence may be too low; screening 0 National National Lisbon 68.6 (3280) 48.8 (3367) (502) 57.5 (2806) 50.9 (3980) 48.7 (726) centres, detoxification units; IDU status unknown prevalence may be too low; screening centres, therapeutic communities; IDU status unknown prevalence may be too low; screening centres; IDU status unknown prevalence may be too low; screening Lisbon Xabregas 70.0 (203) 72.8 (80) 45.3 (06)

28 Lisbon -Xabregas / 65.8 (407) centre; IDU status unknown, prevalence may be too low. 8 Lisbon -Taipas 65.9 (320) centre; IDU status unknown, prevalence may be too low. 8 Lisbon Taipas 73.7 (38) 7 Lisbon Casal Ventoso 82 (94) Low threshold services in high problem area; IDU status unknown prevalence may be too low. 9, 20 Lisbon Casal Ventoso 74 (252) Low threshold 4 services in high problem area, data 998/99; IDU status unknown prevalence may be too low, screening

29 North / 44.9 (775) 49.3 (87) centres; IDU status unknown prevalence may be too low; screening 0 Urban Region of Porto 76.2 (2) 4 Porto 87.6 (443) 8 Porto Porto -Boavista Central 87.8 (443) 58. (45) 37.0 (883) 37.5 (890) centre; IDU status unknown, prevalence may be too low. centre; IDU status unknown, prevalence may be too low. centres; IDU status unknown prevalence may be too low; screening 8 2 0

30 Coimbra / 70.4 (227) 82.0 (06) centres, public health laboratory, pregnant IDUs; screening 2 Évora 84.8 (33) 6 Santarém 92.4 (66) 7 Sintra 90 (20) 7 Region? 76 (448)?? Setting? 9 Algarve 46.8 (380) 4 (34) centres; IDU status unknown prevalence may be too low; screening 0

31 Algarve / 53.3 (5) 83.3 (2) 88.9 (9) 9.7 (2) 00 (2) 94. (7) 8.8 () 77.8 (9) Alentejo 53.8 (3) 50.0 (36) centres; IDU status unknown prevalence may be too low; screening 0 Lisbon - Leiria - Porto 6.9 (8)?? 3 prisons, saliva. 5 Setúbal 92 (238)?? Setting? 9 Setúbal 95. (23)?? centre; IDU status unknown, prevalence may be too low. 9 Setúbal - Almada 85.2 (230)?? centre; data

32 / Finland, Helsinki 63 (35) 55.9 (59) 52.0 (99) Needle exchanges, screening saliva., 5, 8 Finland, Helsinki 72.7 (22) 33.5 (94) 33.2 (274) Needle exchanges, screening Finland, Vantaa 50 (20) 44.6 (92) 30.2 (49) Needle exchanges, screening, 8 Finland, Vantaa 43.4 (83) 42.7 (82) Needle exchange, screening saliva, 8 Finland, Tampere 2.6 (26) 6.6 (229) Needle exchanges, screening Finland, National 38.4 (46) Overdose deaths, screening

33 Finland, National / 52.0 (34) Prisons, screening saliva.

34 / Sweden, 90.4 Syringe/needle exchange; data 990 and Sweden, Stockholm 9. (93) Remand prison and hospital; screening; 6% nonparticipation. 2

35 / UK, 30.9 (27) 29.0 (2940) 29.7 (2866) 32.2 (2448) centres, needle exchange, low threshold services, primary care and outreach; screening saliva. UK, England and Wales excl. London 9. (54) Community surveys; current IDUs, screening saliva. 3 UK, England and Wales 35. (3366) 32.4 (373) 32.7 (3425) 34.6 (2963) centres, needle exchange, low threshold services, primary care and outreach; screening saliva. UK, England 29.8 (805) Prisons, ever IDUs, screening saliva. 4 UK, England 65.3 (72) ; ever injectors; data 996 and 997 2

36 UK, London / 52.2 (655) 45. (79) 48.3 (559) 45.8 (55) centres, needle exchange, low threshold services; screening saliva. UK, London 3.9 (226) Community surveys; current IDUs, screening saliva. 3 UK, Glasgow 63. (306) (40) (39) 56.4 (95) centres, needle exchanges, street, screening saliva. 8 UK, Greater Glasgow 77 (370) (32) (463) / Public health 9 laboratories; serum taken for named HIV testing. UK, Lothian 58 (306) (307) (327) / Public health 9 laboratories; serum taken for named HIV testing.

37 UK, Aberdeen / 44.2 (43) Prison; ever injectors; screening saliva. 6 UK, Perth 57 (6) Prison; ever injectors; screening saliva. 6 UK, Cornton Vale 54 (39) Prison; ever injectors; screening saliva. 6 UK, Barlinnie 53 (308) Prison; ever injectors; screening saliva. 6 UK, Liverpool 68.3 (530) UK, Liverpool 67 (30)??, HIV prevention centre, infectious diseases unit. data ?? Hospital inpatients. 7

38 / UK, Lowmoss 3.8 (85) Prison; ever injectors; screening saliva. 6 UK, England & Wales 67. (33) Public health laboratories. data UK, Glasgow 93 (48)?? Laboratory. 4 UK, East Anglia 5 (00)?? Needle exchange. 5 UK, Scotland 49 (536) Prison; ever injectors; screening saliva. 6

39 Notes:. Sample size is the number of positive plus negative tests (total valid tests). Prevalence is number positive divided by total valid tests, excluding missing values. Prevalence from sample size under 50 is not reliable. 2. Self-reported test results for HCV may be unreliable. Prevalence is number reporting a positive test result divided by the number reporting a positive or negative result. 3. Saliva tests for hepatitis C antibodies underestimate prevalence. If test sensitivity is known then figures can be adjusted upwards by dividing prevalence by test sensitivity. Test sensitivity is around 70-90% in older studies and may be up to 90-95% in some recent studies. Figures have not been adjusted. 4. Having health problems is one selection criterion for admission to drug treatment in some countries or cities (Greece, Rome), due to long waiting lists or special programmes for infected IDUs, this may result in upward bias of prevalence. Prevalence from treatment data should therefore be interpreted in combination with non-treatment data. 5. Data sources with no information on injecting status were excluded as far as possible, as such prevalence can severely underestimate prevalence among injectors in the same source. Some such sources were however included if samples were large or they provided trends over time, in which case it is indicated that injecting status is unknown and prevalence among injectors may be underestimated. * See Box 6 OL: Data sources prevalence ( for details of sources. =diagnostic testing; =specific prevalence study; SR=prevalence study based on self-reported test results Part of these data were taken from two literature reviews on HCV prevalence in Europe, most figures were subsequently checked by the national focal points. These reviews are: - Mathei C, Buntinx F, van Damme P. Seroprevalence of hepatitis C markers among intravenous drug users in western European countries: a systematic review. J Viral Hepat 2002; 9: Roy K, Hay G, Andragetti R, Taylor A, Goldberg D, Wiessing L. Monitoring hepatitis C virus infection among injecting drug users in the European Union: a review of the literature. Epidemiol Infect 2002; 29: