During the 1990s, the prevalence of hepatitis C virus and HIV among this high risk group was relatively low compared with other countries. However, targets to prevent bloodborne viruses have been absent from the UK government's drug strategy in recent years.

In 2001, 428 new injecting drug users, mainly from London, completed questionnaires and provided samples to test for antibodies to hepatitis C virus and HIV.

Incidence of hepatitis C virus was high (41.8 cases per 100 person years) and of HIV was higher than expected (3.4 cases per 100 person years). These figures are supported by ongoing surveillance data, and suggest that transmission may have recently increased, say the authors.

Possible explanations for the rise include changes in patterns of injecting drug use and injecting risk behaviour in newer drug users than those injecting in the early to mid-1990s. In addition, there may have been increases in the number of injecting drug users over and above any increase in protective measures.

The authors argue that current drug policy is failing to protect this high risk group from bloodborne viruses. Innovative strategies are required to change behaviour and to deliver health education messages and harm reduction strategies early enough to make a difference, they conclude.

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Contact: Emma Dickinson
edickinson@bmj.com
44-207-383-6529
BMJ-British Medical Journal
11-Nov-2004