Epidemiology and Infection

Original Papers

Hepatitis

Hepatitis C prevalence in injecting drug users in Europe, 1990–2007: impact of study recruitment setting

M. RONDYa1a2 c1, L. WIESSINGa3, S. J. HUTCHINSONa4a5, C. MATHEÏa6, F. MATHISa7, V. MRAVCIKa8, L. NORDENa9, M. ROSIŃSKAa10, O. SCUTELNICIUCa11, B. SULIGOIa12, F. VALLEJOa13, M. VAN VEENa1 and M. KRETZSCHMARa1a14

a1 Centre for Infectious Disease Control, National Institute for Public Health and the Environment, The Netherlands

a2 European Programme for Intervention Epidemiology Training (EPIET), European Centre for Diseases Prevention and Control (ECDC), Sweden

a3 European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Portugal

a4 Health Protection Scotland, Glasgow, UK

a5 Department of Mathematics and Statistics, University of Strathdyde, Glasgow, UK

a6 Academic Centre of General Practice, Katholieke Universiteit Leuven, Belgium

a7 ASL TO3 – Piedmont Centre for Drug Addiction Epidemiology (OED), Italy

a8 National Monitoring Centre for Drugs and Drug Addiction, Czech Republic

a9 Karolinska Institutet, Sweden

a10 National Institute of Public Health – National Institute of Hygiene, Warsaw, Poland

a11 National Centre of Health Management, Republic of Moldova

a12 Istituto Superiore di Sanità, Italy

a13 Instituto de Salud Carlos III, Spain

a14 Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands

SUMMARY

Monitoring injecting drug users' (IDUs) health is challenging because IDUs form a difficult to reach population. We examined the impact of recruitment setting on hepatitis C prevalence. Individual datasets from 12 studies were merged. Predictors of HCV positivity were sought through a multilevel analysis using a mixed-effects logistic model, with study identifier as random intercept. HCV prevalence ranged from 21% to 86% across the studies. Overall, HCV prevalence was higher in IDUs recruited in drug treatment centres compared to those recruited in low-threshold settings (74% and 42%, respectively, P < 0·001). Recruitment setting remained significantly associated with HCV prevalence after adjustment for duration of injecting and recent injection (adjusted odds ratio 0·7, 95% confidence interval 0·6–0·8, P = 0·05). Recruitment setting may have an impact on HCV prevalence estimates of IDUs in Europe. Assessing the impact of mixed recruitment strategies, including respondent-driven sampling, on HCV prevalence estimates, would be valuable.

(Received December 21 2011)

(Revised March 22 2012)

(Accepted April 16 2012)

(Online publication May 17 2012)

Key words

  • Estimating;
  • hepatitis C;
  • injecting drug use;
  • prevalence of disease;
  • surveillance

Correspondence:

c1 Author for correspondence: Mr M. Rondy, 90 rue d'Amsterdam, 75011 Paris, France. (Email: marc.rondy@gmail.com)

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