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Seroprevalence of HIV, hepatitis b, and hepatitis c among opioid drug users on methadone treatment in the netherlands

Imke Schreuder1,2*, Marianne AB van der Sande2,6, Matty de Wit3, Monique Bongaerts4, Charles AB Boucher1, Esther A Croes5 and Maaike G van Veen2

Author Affiliations

1 Department of Virology, Erasmus MC, (Dr. Molewaterplein 50), Rotterdam (3000 CA) the Netherlands

2 Department of Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute of Public Health and Environment, (Antonie van Leeuwenhoeklaan 9) Bilthoven (3721 MA), the Netherlands

3 Department of Epidemiology, Documentation and Health Promotion, Public Health Service, (Nieuwe Achtergracht 100) Amsterdam (1018 WT), the Netherlands

4 Division Addiction Care Group, Mondriaan centre, (Valkenburgerweg 17) Heerlen (6411 BM), the Netherlands

5 Department of Prevention, Trimbos-institute, (Da Costakade 45) Utrecht (3521 VS), the Netherlands

6 Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, (Heidelberglaan 100) Utrecht (3508 GA), the Netherlands

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Harm Reduction Journal 2010, 7:25 doi:10.1186/1477-7517-7-25

Published: 26 October 2010

Abstract

Background

Injecting drug users (IDU) remain an important population at risk for blood-borne infections such as human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV). In the Netherlands, a program is being implemented to offer annual voluntary screening for these infections to opioid drug users (ODUs) screened in methadone care. At two care sites where the program is now operating, our study aimed to estimate the seroprevalence among ODUs screened for HIV, HBV and HCV; to evaluate HBV vaccination coverage; and to assess the feasibility of monitoring seroprevalence trends by using routine annual screening data.

Methods

Opioid drug users on methadone treatment are routinely offered voluntary screening for infectious diseases such as HIV, HBV and HCV. Data on uptake and outcome of anti-HIV, anti-HBc, and anti-HCV screening among ODUs receiving methadone were obtained from two regions: Amsterdam from 2004 to 2008 and Heerlen from 2003 to 2009.

Findings

Annual screening uptake for HIV, HBV and HCV varied from 34 to 69%, depending on disease and screening site. Of users screened, 2.5% were HIV-positive in Amsterdam and 11% in Heerlen; 26% were HCV-positive in Amsterdam and 61% in Heerlen. Of those screened for HBV, evidence of current or previous infection (anti-HBc) was found among 33% in Amsterdam and 48% in Heerlen. In Amsterdam, 92% were fully vaccinated for HBV versus 45% in Heerlen.

Conclusion

Annual screening for infectious diseases in all ODUs in methadone care is not fully implemented in the Netherlands. On average, more than half of the ODUs in methadone care in Heerlen and Amsterdam were screened for HIV, HBV and HCV. In addition, screening data indicate that HBV vaccination uptake was rather high. While the HIV prevalence among these ODUs was relatively low compared to other drug-using populations, the high HCV prevalence among this group underscores the need to expand annual screening and interventions to monitor HIV, HBV and HCV in the opioid drug-using population.