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

S. McDonald, M. Kretzschmar, S. Hutchinson, D. Goldberg

Research output: Contribution to journalConference Contribution

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.
LanguageEnglish
Article numberP2-181
PagesA271-A271
Number of pages1
JournalJournal of Epidemiology and Community Health
Volume65
Issue numberSupplement 1
DOIs
Publication statusPublished - Aug 2011
EventIEA World Congress of Epidemiology - Edinburgh, United Kingdom
Duration: 7 Aug 201111 Aug 2011

Fingerprint

Scotland
Hepatitis C
Hepacivirus
Incidence
Infection
Harm Reduction
Public Health
Pharmaceutical Databases
Health Planning
Hepatitis C Antibodies
Mortality
Methadone
Syringes
Virus Diseases
Drug Users
Needles
Liver Diseases
Databases
Injections
Population

Keywords

  • hepatitis C
  • IDUs
  • Scotland
  • injecting drug user

Cite this

McDonald, S. ; Kretzschmar, M. ; Hutchinson, S. ; Goldberg, D. / Reconstructing the historical incidence of hepatitis C infection among Scotland's IDUS. In: Journal of Epidemiology and Community Health. 2011 ; Vol. 65, No. Supplement 1. pp. A271-A271.
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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.",
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McDonald, S, Kretzschmar, M, Hutchinson, S & Goldberg, D 2011, 'Reconstructing the historical incidence of hepatitis C infection among Scotland's IDUS' Journal of Epidemiology and Community Health, vol. 65, no. Supplement 1, P2-181, pp. A271-A271. https://doi.org/10.1136/jech.2011.142976j.16

Reconstructing the historical incidence of hepatitis C infection among Scotland's IDUS. / McDonald, S.; Kretzschmar, M.; Hutchinson, S.; Goldberg, D.

In: Journal of Epidemiology and Community Health, Vol. 65, No. Supplement 1, P2-181, 08.2011, p. A271-A271.

Research output: Contribution to journalConference Contribution

TY - JOUR

T1 - Reconstructing the historical incidence of hepatitis C infection among Scotland's IDUS

AU - McDonald, S.

AU - Kretzschmar, M.

AU - Hutchinson, S.

AU - Goldberg, D.

PY - 2011/8

Y1 - 2011/8

N2 - 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.

AB - 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.

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KW - Scotland

KW - injecting drug user

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DO - 10.1136/jech.2011.142976j.16

M3 - Conference Contribution

VL - 65

SP - A271-A271

JO - Journal of Epidemiology and Community Health

T2 - Journal of Epidemiology and Community Health

JF - Journal of Epidemiology and Community Health

SN - 0143-005X

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ER -