9 November 2012
A report from the Health Protection Agency (HPA) has found that half of people who inject drugs are infected with hepatitis C, one in 100 have HIV and a third have a bacterial infection as a result of their injecting. Almost a quarter of younger injectors (those aged under 25) continue to share needles and syringes.
In 2011, one in six people who inject drugs were found to have been infected with the hepatitis B virus at some point in their lives. This is a large fall from 2001 when over a quarter had been infected. This fall is due to a programme of hepatitis B vaccination which has specifically targeted this group and in 2011, 76 per cent of injectors accepted the vaccination, up from 37 per cent in 2001.
The report, ‘Shooting Up – Infections among people who inject drugs in the UK 2011’ is published today.
People who inject drugs are vulnerable to a wide range of viral and bacterial infections which can result in a high level of illness and death. The most common viral infections seen in drug users are hepatitis B and C. Both of these cause inflammation of the liver and are caused by contact with infected blood. In drug users this contact is caused by the sharing of needles and syringes and other equipment used in injecting drugs.
The proportion of people who inject drugs who have been infected with hepatitis C, for which there is no vaccine, has changed little over the last 10 years. A total of 12,642 hepatitis C infections were diagnosed in the UK in 2011, around nine in ten of these infections were acquired through injecting drugs.
In 2011 there were 132 new HIV diagnoses in the UK where infection had been acquired through injecting drugs. Around one in 100 injectors is living with HIV; this is low in comparison to many other European countries. Although the level in the UK has remained much the same as it was in 2001, a number of other European countries which also had low levels – for example Romania and Greece - have recently experienced large HIV outbreaks among people who inject drugs.
There were no cases of anthrax, botulism and tetanus in this group reported in 2011, but anthrax cases among people who inject drugs has re-emerged during 2012 and there have been 12 cases across Europe this year, including five in the UK.
Dr Fortune Ncube, an expert in infections among people who inject drugs at the HPA, said: “The increased uptake of hepatitis B vaccination is very encouraging and the effect of this programme can be seen in the lower rates of infection. This group needs to continue to be targeted to ensure that these new low levels of infection continue to go down in the future.
“People who inject drugs will always be at risk of infections owing to the piercing of the skin providing an opportunity for bacteria and viruses to get into the body. Although levels of hepatitis B have greatly reduced, other infections are not declining.
“The sharing of syringes and needles is also a huge health hazard. Rates of sharing drug paraphernalia have declined over the years but it does continue particularly among young people, which is a worry. People need to be encouraged to use community-based initiatives to get clean needles and be actively supported in getting off drugs.”
1. The full report can be found on the HPA website.
2. The report recommends that those commissioning community-based services aimed at reducing the harm associated with injecting drug use should give appropriate priority to preventing the spread of infections among people who inject drugs. National drug strategies acknowledge that tackling drug-related harm is vital to reducing infections as a component of recovery. Responses should therefore be in line with these strategies, relevant action plans, related guidance and local needs’ assessments through the provision of:
a) Information and advice on safer injecting practices, avoiding injecting site infections, preventing blood-borne virus transmission and the safe disposal of used equipment.
b) Hepatitis B and tetanus vaccination and, where indicated, hepatitis A vaccination.
c) Diagnostic testing for HIV and hepatitis C, and as appropriate for hepatitis B, and care pathways for those infected. These should ensure that those who continue to inject after being diagnosed with hepatitis infection have access to antiviral treatments in line with Clinical Guidelines.
d) Health checks and treatment for injection site infections.
e) Interventions to decrease or stop injecting and to support safer injection practice where it continues.
3. More information about the current outbreak of anthrax in people who inject drugs can be found on the HPA website.
4. The Health Protection Agency is an independent UK organisation that was set up by the government in 2003 to protect the public from threats to their health from infectious diseases and environmental hazards. In April 2013 the Health Protection Agency will become part of a new organisation called Public Health England, an executive agency of the Department of Health. To find out more, visit our website: http://www.hpa.org.uk or follow us on Twitter @HPAuk or ‘Like’ us on Facebook at www.facebook.com/HealthProtectionAgency
5. For more information please contact the national HPA press office at Colindale on 0208 327 7901 or email firstname.lastname@example.org. Out of hours the duty press officer can be contacted on 0208 200 4400.
Last reviewed: 9 November 2012