Success in preventing HIV has not been mirrored for hepatitis C

Papers p 433

Injecting drug users have been capable of reducing their risky behaviour in the face of the HIV-AIDS epidemic.1 To many this risk reduction, shown in numerous studies from different parts of the world, was unexpected as drug users are often regarded as self destructive. Nevertheless, because of the decrease in risky behaviour, the incidence of HIV infection among drug users in most industrialised countries has declined over the years. Thus, in this issue, van Beek et al report that among young injecting drug users in Sydney the incidence of HIV infection in 1992-5 was only 0.2 per 100 person years (p 433).2 Not so good is their finding that the incidence of infection with hepatitis C virus (HCV) was extremely high: 21 per 100 person years; among those aged under 20 the rate was 76 per 100 person years. Other groups from different countries have also reported a continuing high prevalence and incidence of hepatitis C virus among injecting drug users,3 though not as high as in this study; this may be to do with the young …