Skip to main content
SpringerLink
Log in

Hepatitis C infection among drug users attending general practice

  • Original Papers
  • Published:
Irish Journal of Medical Science Aims and scope Submit manuscript

Abstract

Background The prevalence of hepatitis C (HCV) infection among injection drug users is high and addiction-related care is increasingly being provided by GPs in Ireland.

Aims To determine the prevalence and associated factors of HCV infection among injecting drug users attending general practice.

Methods The records of 571 patients attending 42 general practices in the Eastern Regional Health Authority (ERHA) area for methadone maintenance treatment were reviewed.

Results The HCV status was recorded in 380 cases (67%). Of these, 193 had a test performed by their GP, 74 had been tested by another service and 113 had no evidence of being tested, but HCV status was recorded based on information provided by the patient himself. A total of 276 cases were identified as being HCV positive (prevalence 73%), with no difference in prevalence between the three sources of information (p=0.12). A history of injecting drug use was the major determinant of testing for HCV.

Conclusions While a large proportion of drug users attending GPs for methadone maintenance treatment are known to be HCV positive, a considerable number have not been tested. Barriers to testing need to be explored to facilitate comprehensive screening.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Singh S, Miller R, Madge S, Patch D. Impact of hepatitis C in general practice.Br J Gen Pract 2000; 50: 532–36.

    PubMed  CAS  Google Scholar 

  2. Choo Q-L, Kuo G, Weiner A. Isolation of a cDNA clone derived f rom a blood-borne non-A, non-B viral hepatitis genome.Science 1989; 244: 359–62.

    Article  PubMed  CAS  Google Scholar 

  3. Alter M, Margolis H, Krawczynski K. The natural history of community acquired hepatitis C in the United States.N Engl J Med 1992; 327: 1899–905.

    PubMed  CAS  Google Scholar 

  4. Stevens C, Taylor P, Pindyck J, Choo Q-L, Bradley D, Kuo G, et al. Epidemiology of hepatitis C virus: a preliminary study in volunteer blood donors.J Am Med Ass 1990; 263: 49–53.

    Article  CAS  Google Scholar 

  5. Weiner A, Kuo G, Bradley D, Bonino F, Saracco G, Lee C, et al. Detection of hepatitis C viral sequences in non-A, non-B hepatitis.Lancet 1990; 335: 1–3.

    Article  PubMed  CAS  Google Scholar 

  6. Van derPoel C, Cuypers H, Reesink H. Hepatitis C virus six years on.Lancet 1994; 344: 1475–79.

    Article  PubMed  Google Scholar 

  7. Tsukuma H, Hiyama T, Tanaka S. Risk factors for hepatocellular carcinoma among patients with chronic liver disease.N Engl J Med 1993; 328: 1797–1801.

    Article  PubMed  CAS  Google Scholar 

  8. Brown K, Crofts N. Health care costs of a continuing epidemic of hepatitis C virus infection among drug users.Aus NZ J Pub Health 1998; 22: 384–88.

    Article  CAS  Google Scholar 

  9. Comiskey C, Barry J. A capture - recapture study of the prevalence and implications of opiate use in Dublin.Eur J Pub Health 2001; 11(2): 198–200.

    Article  CAS  Google Scholar 

  10. Farrell M, Howes S, Vester A, Davoli M. Reviewing current practice in drug substitution treatment in Europe. EMCDDA, Osservatorio Epidemiologico 1999.

  11. Keenan E, Barry J. Managing drug misuse in general practice.Br Med J 1999; 319: 1497.

    CAS  Google Scholar 

  12. Report of the sub-committee on the care and management of persons with HIV / AIDS to the National AIDS Strategy Committee. Dublin: National AIDS Strategy Committee, 1992.

  13. Report of the Expert Group on the Establishment of a protocol for the prescribing of methadone. Dublin: Department of Health, 1993.

  14. Misuse of drugs (supervision of prescription and supply of methadone) regulations (Statutory Instrument No 225). Dublin: Department of Health, 1998.

  15. Poynard T, McHutchinson J, Davis G, Esteban-Muir R, Goodman Z, Bedossa P, et al. Impact of interf e ron alfa-2b and ribavarin on progression of liver fibrosis in patients with chronic hepatitis C.Hepatology 2000; 32: 1131–37.

    Article  PubMed  CAS  Google Scholar 

  16. Technology Appraisal Guidance Number 14. Guidance on the use of ribavarin and interf e ron alpha for hepatitis C. London: NHS National Institution for Clinical Excellence, 2000.

    Google Scholar 

  17. (Dublin Area Hepatitis C Initiative Group). Hepatitis C among drug users in Eastern Regional Health Authority area: consensus guidelines on management in general practice.Ir J Med Sci 2003: In publication.

  18. Smyth R, Keenan E, Dorman A, O’Connor J. Hepatitis C infection among injecting drug users attending the National Drug Treatment Centre.Ir J Med Sci 1995; 164(4): 267–68.

    Article  PubMed  CAS  Google Scholar 

  19. Smyth R, Keenan E, O’Connor J. Bloodborne viral infection in Irish injecting drug users.Addiction 1998; 93(11): 1649–1656.

    Article  PubMed  CAS  Google Scholar 

  20. Allwright S, Bradley F, Long J, Barry J, Thornton L, Parry J. P revalence of antibodies to hepatitis B, hepatitis C and HIV among Irish prisoners: results of a national cross sectional survey.Br Med J 2000; 321: 78–82.

    Article  CAS  Google Scholar 

  21. Census 96: Principal demographic results. Dublin: Stationery Office, 1997.

  22. Cullen W, Bury G, O’Kelly F, Barry J. Drug users attending general practice in the Eastern Regional Health Authority area.Ir Med J 2000; 93(7): 214–17.

    PubMed  CAS  Google Scholar 

  23. Asch S, Connor SE, Hamilton EG, Fox SA. Problems in recruiting community-based physicians for health services research.J Gen Intern Med 2000; 15(8): 591–9.

    Article  PubMed  CAS  Google Scholar 

  24. Fitzgerald M, Barry J, O’Sullivan P, Thornton L. Bloodborne virus infections in Dublin’s opiate users.Ir J Med Sci 2001; 170(1): 32–34.

    Article  PubMed  CAS  Google Scholar 

  25. O’Higgins K. Treated drug misuse in the Greater Dublin Area: A review of five years 1990-1994. Dublin: Health Research Board, 1996.

    Google Scholar 

  26. Peat M, Budd J, Burns S, Robertson R. Audit of bloodborne virus infections in injecting drug users in general practice.Comm Dis Pub Health 2000; 3(4): 244–46.

    CAS  Google Scholar 

  27. Downing M, Mulia N, Ve rnon K, Knight K, Ferreboeuf M, Carroll A. Voices from the field: providers discuss HIV counseling and testing p rograms for drug users.AIDS Public Policy J 2000; 15(2): 48–64.

    PubMed  CAS  Google Scholar 

  28. Crofts N, Nigro L, Oman K, Stevenson E, Sherman J. Methadone maintenance and hepatitis C virus infection among injecting drug users.Addiction 1997; 92(8): 999–1005.

    Article  PubMed  CAS  Google Scholar 

  29. Van Beek I, Buckley R, Stewart M, MacDonald M, Kaldor J. Risk factors for hepatitis C virus infection among injecting drug users in Sydney.Genitourinary Med 1994; 70(5): 321–24.

    Google Scholar 

  30. Thornton L, Barry J, Long J, Allwright S, Bradley F, Parry J. Comparison between self-re p o rted hepatitis B, hepatitis C and HIV antibody status and oral fluid assay results in Irish prisoners.Comm Dis Pub Health 2000; 3(4): 253–55.

    CAS  Google Scholar 

  31. Crespo J, Lozano J, Carte B, de las Heras B, de la Cruz F, Pons-Romero F. Viral replication in patients with concomitant hepatitis B and C virus infections.Eur J Clin Micro Inf Dis 1997; 16(6): 445–451.

    Article  CAS  Google Scholar 

  32. Shev S, Dhillon A, Lindh M, Serleus Z, Wejstal R, Widell A, Norkrans G et al. The importance of cofactors in the histologic pro g ression of minimal and mild chronic hepatitis C.Liver 1997; 17(5): 215–223.

    PubMed  CAS  Google Scholar 

  33. Sabin C. Hepatitis C virus and HIV coinfection.AIDS Patient Care STDS 1998; 12(3): 199–207.

    PubMed  CAS  Google Scholar 

  34. Immunological responses to hepatitis C and non-hepatitis C antigens in hepatitis C (HCV) and human immunodeficiency (HIV)-HCV coinfected patients. XIII International AIDS Conference; 2000; Durban, South Africa.

  35. Bell J, Batey R, Farrell G, Crewe E, Cunningham A, Byth B. Hepatitis C in intravenous drug users.Med J Aust 1990; 153: 274–76.

    PubMed  CAS  Google Scholar 

  36. Van Ameijden E, Van denHoek J, Mjientjies G, Coutinho R. A longitudinal study on the incidence and transmission patterns of HIV, HBV, and HCV infection among drug users in Amsterdam.Eur J Epidemiol 1993; 9(3): 255–262.

    Article  PubMed  Google Scholar 

  37. Fingerhood M, Jasinski D, Sullivan J. Prevalence of hepatitis C in a chemically dependent population.Arch Int Med 1993; 153(17): 2025–30.

    Article  CAS  Google Scholar 

  38. Galeazzi B, Tufano A, Barbierato E, Bortolloti F. Hepatitis C virus infection in Italian intravenous drug users: epidemiological and clinical aspects.Liver 1995; 15: 209–212.

    PubMed  CAS  Google Scholar 

  39. Thomas D, Vlahov D, Solomon L, Cohn S, Taylor E, Garfein R, etal. Correlates of hepatitis C virus infections among injection drug users.Medicine 1995; 74(4): 212–20.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of General Practice, Dr Steeven’s Hospital, Dublin

    W Cullen & G Bury

  2. University College Dublin, Department of Community Health and General Practice, Dr Steeven’s Hospital, Dublin

    J Barry & FD O’Kelly

  3. Trinity College Dublin, Department of Public Health Medicine, Dr Steeven’s Hospital, Dublin

    J Barry

  4. Eastern Regional Health Authority Area, Eastern Regional Vocational Training Programme in General Practice, Dr Steeven’s Hospital, Dublin

    FD O’Kelly

Authors
  1. W Cullen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G Bury
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J Barry
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. FD O’Kelly
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to W Cullen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cullen, W., Bury, G., Barry, J. et al. Hepatitis C infection among drug users attending general practice. Ir J Med Sci 172, 123–127 (2003). https://doi.org/10.1007/BF02914496

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02914496

Keywords

Search

Navigation