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J Epidemiol Community Health. 1997 December; 51(6): 692–697.
PMCID: PMC1060568

Epidemiology of hepatitis C virus infection among injecting drug users in Australia.


STUDY OBJECTIVE: To review the epidemiology of hepatitis C virus (HCV) infection among injecting drug users (IDUs) in Australia, and consider needs for further research and prevention policies and programmes. DESIGN: (1) Review of the results of surveillance for HCV; (2) review of published literature on prevalence, incidence, and risk factors for HCV among IDUs; and (3) reconstruction of incidence rates from prevalence studies of HCV in IDUs. SETTING AND PARTICIPANTS: Field and clinic based studies of IDUs in Australia. MAIN RESULTS: HCV has been present at high prevalences (of the order of 60-70%) in populations of Australian IDUs since at least 1971. Duration of injecting and main drug injected were the main predictors of seropositivity, the latter possibly a surrogate for frequency of injecting and both together as surrogate for cumulative numbers of times injected. Risk of infection begins with first injection and continues as long as injecting does. Current incidence is approximately 15 per 100 person years, and up to 40 per 100 person years in some subpopulations. Incidence may have decreased through the 1980s as a result of behaviour change in relation to HIV, as it has for hepatitis B, but not significantly so. CONCLUSIONS: Control of HCV infection in Australia will depend on effectiveness of measures to control HCV spread among IDUs. This will be a greater challenge than the control of HIV in this population has been. Needs identified include improved surveillance, especially for recently acquired infection, better understanding of exact transmission modes, and urgent improvement in prevention strategies.

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  • Choo QL, Kuo G, Weiner AJ, Overby LR, Bradley DW, Houghton M. Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome. Science. 1989 Apr 21;244(4902):359–362. [PubMed]
  • Kuo G, Choo QL, Alter HJ, Gitnick GL, Redeker AG, Purcell RH, Miyamura T, Dienstag JL, Alter MJ, Stevens CE, et al. An assay for circulating antibodies to a major etiologic virus of human non-A, non-B hepatitis. Science. 1989 Apr 21;244(4902):362–364. [PubMed]
  • Alter MJ, Margolis HS, Krawczynski K, Judson FN, Mares A, Alexander WJ, Hu PY, Miller JK, Gerber MA, Sampliner RE, et al. The natural history of community-acquired hepatitis C in the United States. The Sentinel Counties Chronic non-A, non-B Hepatitis Study Team. N Engl J Med. 1992 Dec 31;327(27):1899–1905. [PubMed]
  • Stevens CE, Taylor PE, Pindyck J, Choo QL, Bradley DW, Kuo G, Houghton M. Epidemiology of hepatitis C virus. A preliminary study in volunteer blood donors. JAMA. 1990 Jan 5;263(1):49–53. [PubMed]
  • Abildgaard N, Peterslund NA. Hepatitis C virus transmitted by tattooing needle. Lancet. 1991 Aug 17;338(8764):460–460. [PubMed]
  • Donahue JG, Muñoz A, Ness PM, Brown DE, Jr, Yawn DH, McAllister HA, Jr, Reitz BA, Nelson KE. The declining risk of post-transfusion hepatitis C virus infection. N Engl J Med. 1992 Aug 6;327(6):369–373. [PubMed]
  • Tsukuma H, Hiyama T, Tanaka S, Nakao M, Yabuuchi T, Kitamura T, Nakanishi K, Fujimoto I, Inoue A, Yamazaki H, et al. Risk factors for hepatocellular carcinoma among patients with chronic liver disease. N Engl J Med. 1993 Jun 24;328(25):1797–1801. [PubMed]
  • van der Poel CL, Cuypers HT, Reesink HW. Hepatitis C virus six years on. Lancet. 1994 Nov 26;344(8935):1475–1479. [PubMed]
  • Zuckerman AJ, Zuckerman JN. Prospects for hepatitis C vaccine. J Hepatol. 1995;22(1 Suppl):97–100. [PubMed]
  • Crofts N, Hopper JL, Bowden DS, Breschkin AM, Milner R, Locarnini SA. Hepatitis C virus infection among a cohort of Victorian injecting drug users. Med J Aust. 1993 Aug 16;159(4):237–241. [PubMed]
  • Moaven LD, Crofts N, Locarnini SA. Hepatitis C virus infection in Victorian injecting drug users in 1971. Med J Aust. 1993 Apr 19;158(8):574–574. [PubMed]
  • Liddle C, Crewe EB, Swanson NR, Jeffrey GP, Cunningham AL, Reed WD, Batey RG, Farrell GC. Does hepatitis C virus play a role in "non-viral" chronic liver disease? Med J Aust. 1990 Sep 3;153(5):265–271. [PubMed]
  • Uyttendaele S, Claeys H, Mertens W, Verhaert H, Vermylen C. Evaluation of third-generation screening and confirmatory assays for HCV antibodies. Vox Sang. 1994;66(2):122–129. [PubMed]
  • Gaughwin M, Dodding J, Ali R. Hepatitis C and the history of injecting drug use in South Australia. Med J Aust. 1994 Aug 15;161(4):286–287. [PubMed]
  • Crofts N, Stewart T, Hearne P, Ping XY, Breshkin AM, Locarnini SA. Spread of bloodborne viruses among Australian prison entrants. BMJ. 1995 Feb 4;310(6975):285–288. [PMC free article] [PubMed]
  • Waddell RG. Hepatitis C and the history of injecting drug use in South Australia. Med J Aust. 1994 Aug 15;161(4):286–287. [PubMed]
  • Van Ameijden EJ, Van den Hoek JA, Mientjes GH, Coutinho RA. A longitudinal study on the incidence and transmission patterns of HIV, HBV and HCV infection among drug users in Amsterdam. Eur J Epidemiol. 1993 May;9(3):255–262. [PubMed]
  • Crofts N, Ballard J, Chetwynd J, Dickson N, Lindberg W, Watson C. Involving the communities: AIDS in Australia and New Zealand. AIDS. 1994;8 (Suppl 2):S45–S53. [PubMed]
  • Heptonstall J, Mortimer PP. New virus, old story. Lancet. 1995 Mar 11;345(8950):599–600. [PubMed]

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