title: Diagnosis of hepatitis C virus infection in Scotland's injecting drug user population.
abstract: We estimated the extent of undiagnosed hepatitis C virus (HCV) infection in injecting drug users (IDUs) in Scotland. We used record-linkage to determine HCV diagnosis status for 41 062 current/former IDUs attending drug treatment and support services between 1 April 1995 and 31 March 2006; the extent of undiagnosed HCV infection was estimated by comparing the number HCV-diagnosed to the number HCV-infected (estimated from an unlinked anonymous testing survey of 2141 current/former IDUs). In all, 9145 IDUs (22%) were diagnosed HCV antibody-positive since first attendance at drug services (diagnosis rate of 33.6/1000 person-years, 95% CI 32.7-34.4). By 31 March 2006, of the 19 632 current/former IDUs who had attended drug services and were determined to be living with HCV, an estimated 58% (95% CI 45-62) had not been HCV-diagnosed. It is essential that the deployment of resources for identifying at-risk IDUs with a view to offering antiviral therapy is guided by evidence.
authors.affiliation: Health Protection Scotland, Glasgow, UK. smcdonald4@nhs.net
authors.forename: S A
authors.initials: SA
authors.lastname: McDonald
authors.forename: S J
authors.initials: SJ
authors.lastname: Hutchinson
authors.forename: P R
authors.initials: PR
authors.lastname: Mills
authors.forename: S M
authors.initials: SM
authors.lastname: Bird
authors.forename: C
authors.initials: C
authors.lastname: Robertson
authors.forename: J F
authors.initials: JF
authors.lastname: Dillon
authors.forename: A
authors.initials: A
authors.lastname: Springbett
authors.forename: D J
authors.initials: DJ
authors.lastname: Goldberg
mesh_terms: D000328:Adult; D017677:Age Distribution; D015331:Cohort Studies; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification; D006526:Hepatitis C / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D015819:Substance Abuse, Intravenous; D055815:Young Adult