Drug Misuse Statistics Scotland 2007	< Previous | Contents | Next >
C4 Blood-borne viruses Key Points 2006 Hepatitis B Virus Overview In 2006 there were 13 new hepatitis B virus (HBV) diagnoses among persons for whom injecting drug use was indicated as a risk factor (Table C4.1). Five Year Trends – 2002 to 2006 The overall number of new diagnoses of HBV declined between 2002 and 2004 from 354 to 341, but rose in 2005 (372) and 2006 (375). This rise was not reflected in figures for new hepatitis B infected injecting drug users (IDUs) which show a decline between 2002 (38) and 2006 (13) (Table C4.1). Geographical Profile Reports of new hepatitis B cases in IDUs were received from 7 NHS board areas. However, no NHS board reported more than 3 new cases in 2006 (Table C4.1). Hepatitis C Virus Overview In 2006 759 IDU’s were diagnosed with hepatitis C virus (HCV). IDUs accounted for 50% of the 1,519 HCV cases diagnosed in 2006 (Table C4.2). The total number of IDUs known to be infected with the hepatitis C virus is 13,146, accounting for 89% of the 14,765 HCV reports in Scotland for which the possible/probably route of transmission was known. There have been a further 7,306 reports in Scotland where the route of transmission is not known, some of which would be expected to be IDUs (Tables C4.2). Seventy percent of the IDU’s with a diagnosis of HCV were male (Table C4.3). Forty-nine percent of IDUs were recorded as aged under 30 years old when diagnosed with HCV. Four percent were recorded as aged under 20 years old on diagnosis (Table C4.3). Five Year Trends – 2002 to 2006 Between 2002 and 2006 there has been a decrease in the total number of HCV cases reported each year, from 1,795 to 1,519. This decrease has been more marked in the number of IDU HCV cases reported, falling from 1,143 in 2001 to 759 in 2006. However, there was an increase in the number of cases of HCV reported where the probable/possible route of transmission was not known, from 555 in 2002 to 635 in 2006, some of which would be expected to be IDUs (Table C4.2). Geographical Profile Of the 13,146 reports of HCV infected IDUs 44% were from NHS Greater Glasgow and Clyde, a further 15% were from NHS Lothian and 14% were from NHS Grampian (Table C4.2). Human Immunodeficiency Virus and AIDS Overview In 2006 there were 25 new cases of HIV infection among IDUs. Thirteen of these new infections were thought to have been contracted in Scotland (see background information for further details) (Table C4.4). 12 of the new cases were aged 30 to 39 years old at the time of diagnosis and the median age was 35 years (Table C4.6). 18 of the new cases were males (Table C4.6). The cumulative total (to 31 December 2006) of HIV infected reports in IDUs is 1,367. IDUs accounted for 28% of the cumulative total of 4,969 HIV infection reports for Scotland (Table C4.4). Four new AIDS cases were registered among IDUs in 2006, bringing the cumulative total number of cases registered to 439 (Table C4.4). Five Year Trends – 2002 to 2006 Between 2002 and 2006 numbers of HIV infections in IDUs rose: 13 in 2002 rising to 25 in 2006 (Table C4.4). The number of AIDS cases registered has declined from 13 cases in 2002 to 4 cases in 2006 (Table C4.4). There has been a decline over the last five years in the number of HIV infected IDUs in clinical care, from 412 in 2002 to 388 in 2006 (Table C4.7). Geographical Profile Of the 25 new HIV reports in 2006, just under a third were in NHS Lothian (7 reports) and a fifth were in NHS Greater Glasgow and Clyde (5 reports). NHS Tayside reported 4 new infections (Table C4.5). Of the cumulative total of infections 51% of cases were in NHS Lothian (696 of 1,367 reports). A further 22% were in NHS Tayside (304 cases) and 15% (199 cases) in NHS Greater Glasgow (Table C4.5). Background information Hepatitis B Virus Health Protection Scotland (HPS) receives notification of positive hepatitis B Virus (HBV) tests from all laboratories located in the 14 NHS Board areas. At present no standard exists for the reporting of HBV infection and the amount of information provided by the different laboratories varies significantly. Information on risk factors, clinical history and status of HBV markers is frequently missing, thus it is difficult to determine whether cases are acute or chronic and to estimate the true incidence and prevalence of the virus. HPS are currently working towards developing an enhanced surveillance system for HBV in order to improve the quality of data that they receive. Hepatitis C Virus HPS, in association with Scotland’s principal HCV testing laboratories (the West of Scotland Specialist Virus Centre at Gartnavel General Hospital, Glasgow, the East of Scotland Specialist Virus Centre at the Edinburgh Royal Infirmary, the Department of Microbiology at Ninewells Hospital, Dundee, and the Department of Microbiology at Aberdeen Royal Infirmary) collates information on all cases of HCV diagnosed in Scotland. There is no dedicated HCV request form and information is limited to what is available on standard virological test request forms that accompany blood specimens. Revised data – A comprehensive review of all records of diagnoses, received by HPS from HCV testing laboratories, was undertaken in 2005. This established that 6% of records of persons diagnosed HCV positive to December 2003 were duplicates (previously published in HPS weekly reports and included in this publication in previous years); most duplicates applied to the period 2000-2003 and the NHS board area most affected was Grampian where 18% of records had been duplicated. New procedures to reduce the chances of recording duplicate diagnoses have been introduced though HPS, for the purposes of patient confidentiality, only holds the following limited identifiers on individuals: gender, initial of forename, soundex code of surname, date of birth and postcode district of residence. Human Immunodeficiency Virus Voluntary case reporting of HIV and AIDS forms the basis for surveillance in Scotland; this provides information only on diagnosed infections. Data collected by HPS includes limited patient identifiers (initials, soundex code of surname, date of birth, gender and first part of postcode) and risk exposure. Follow-up information such as all AIDS indicator diseases present at the time of the AIDS diagnosis, immunological (CD4 count which is testing to assess the immunological status and thus the stage of HIV disease has reached) monitoring and antiretroviral treatment are linked to cases where relevant. The number of individuals undergoing CD4 count monitoring is a good indicator of the number receiving clinical care. Information is presented here on cases presumed infected in Scotland. This excludes cases where infection is known to have occurred elsewhere in the UK, Europe or the rest of the world. Cases are presumed infected in Scotland unless there is definite evidence of infection elsewhere at the time or in follow-up procedures. Further information Information about HPS data collection and research and statistics on blood-borne viruses are available at http://www.hps.scot.nhs.uk/bbvsti/index.aspx