Injecting drug use is a major risk factor for hepatitis C

10 December 2008

Nearly one-quarter of all laboratory confirmed cases of hepatitis C in England since 1995 were in the North West Region and the majority of these were associated with injecting drug use, the Health Protection Agency's annual report on hepatitis C for 2008 reveals today.

The report discloses that 59,938 cases of hepatitis C have been confirmed in England since 1995 and 13,683 of these were recorded in the North West. As many as 74% of hepatitis C patients questioned in a survey in this region identified injecting drug use, either currently or in the past, as their main risk factor for infection.

Dr. Roberto Vivancos, a Consultant with HPA North West, said: "This is a very worrying but timely report. We need to work hard at raising awareness of hepatitis C and the risk factors for it. Then we need to encourage people who believe that they may have been at risk to be tested so that, if necessary, treatment can be arranged.

"Clearly injecting drug use, or more specifically the sharing of needles, is the major risk factor in this region. People currently in touch with drug services should ask to be tested for hepatitis C. However, it is equally important for former drug users who possibly shared needles in the past, to be tested. Tests can be arranged by family doctors.

"These former drug users may feel fit and well, but it is important for them to know their hepatitis C status so that those who need it can be brought into treatment at an early stage."

Dr Helen Harris, a hepatitis C expert from the Health Protection Agency, agreed: "Hepatitis C is a disease many people associate with current drug use, but we should not forget people who could have been infected many years ago and are unaware of their infection. For example, people may have been infected by sharing needles once or twice when they were younger, and are now living stable everyday lives."

Although injecting drug use (the sharing of needles) is the biggest single factor for hepatitis C, people are also at risk if they have:

• Had medical or dental treatment overseas where infection-control procedures may have been inadequate.
• Had unprotected sex with someone who has the virus
•  Had a body-piercing, tattoo or acupuncture with non-sterile equipment
•  Had a blood-transfusion before 1991. All bloods have been tested for hepatitis C since 1991.

Dr. Vivancos said: "Although we are actively encouraging people who may have been at risk to be tested so that they can be brought into treatment if necessary, it is even more important to raise awareness of the hepatitis C risk factors so that people can take steps to protect themselves and avoid becoming infected in the first place."

The Health Protection Agency advice mirrors that of the Department of Health's Face It Campaign. Namely, it strongly recommends:

• Don't start injecting drugs.
•  Stop injecting if you can.
•  Never share needles, syringes or anything else that may be contaminated with blood.
•  If you or your sexual partner has hepatitis C, there is a small risk that it could be passed on during sex. Condoms reduce this risk. Using condoms will also help protect against unwanted pregnancy, HIV and other sexually-transmitted infections.
•  Don't share razors or toothbrushes

Notes to editors

1. Hepatitis C in the UK - The Health Protection Agency Annual Report 2008 is published by the Health Protection Agency and contributors. To see a full copy of the report, visit: www.hpa.org.uk/hepc2008
2. Anyone who thinks they might be at risk of infection should contact their doctor or nurse or call the Hepatitis C Information Line on 0800 451 451 or visit www.nhs.uk/hepc. For general information about hepatitis C go to www.hpa.org.uk
3. Hepatitis means swelling or inflammation of the liver. The most common cause of hepatitis is viral infections. Hepatitis C infection (also known as Hep C or HCV) is one such virus that can cause long-lasting infection and can lead to liver disease. The UK is the only major developed nation showing an upward trend in the number of deaths from liver disease. Hepatitis C was first identified in 1989.
4. Current mathematical models suggest that around 142,000 individuals aged 15-59 years were chronically infected with hepatitis C in England and Wales in 2003. A separate estimate, based on seroprevalence studies, suggests that there are 12,000 chronically infected individuals in Wales. In Scotland, by the end of 2006, around 38,000 people were estimated to be chronically infected with hepatitis C. Estimates from Northern Ireland suggest that around 4,000 individuals are likely to be chronically infected.
5. Statistical modelling suggests that 31% of prevalent hepatitis C infections are in current injecting drug users (IDUs), 57% are in ex-IDUs and 12% are in the non-IDU population (and were acquired via other routes).
6. For further information please contact Hugh Lamont, Communications Manager, HPA North West, on 0151-482-5728 or 07764-906508.

Last reviewed: 10 December 2008