An annual report on the extent of infections among people who inject drugs in the UK has been published.
The ‘Shooting Up’ report for 2016, published by Public Health England, highlights trends and information on outbreaks of infection across the UK for that year.
People who inject drugs are vulnerable to a wide range of viral and bacterial infections, which can result in high levels of illness and death. Sharing needles and syringes is a highly effective transmission mechanism for HIV, hepatitis B virus and hepatitis C virus.
Public health surveillance of infectious diseases and the associated risk and protective behaviours among people who inject drugs, provides important information to understand the extent of these infections, the risk factors for their acquisition, and for monitoring the effectiveness of prevention measures.
Key points of the report are:
Hepatitis C prevalence remains high and half of those infected are undiagnosed
Hepatitis C remains the most common blood-borne infection among people who inject drugs (PWID), and there are significant levels of transmission among this group in the UK. 2 in every 5 PWID are living with hepatitis C and approximately half of these infections remain undiagnosed. The increasing availability of the new directly acting antiviral drugs provides an opportunity to reduce morbidity and mortality from hepatitis C, and to decrease the risk of onward transmission.
HIV levels remain low, but risks continue
In the UK, around 1 in 100 PWID is living with HIV. Most have been diagnosed and will be accessing HIV care. However, HIV is often diagnosed at a late stage among PWID.
Hepatitis B remains rare, but vaccine uptake needs to be sustained, particularly in younger age groups
In the UK, around 1 in every 200 PWID is living with hepatitis B infection. About three-quarters of PWID report taking up the vaccine against hepatitis B, but this level is no longer increasing, and is particularly low in younger age groups and among those who recently began injecting.
Bacterial infections continue to be a problem
One-third of PWID report having a recent symptom of a bacterial infection. Outbreaks of bacterial infections are continuing to occur in this group.
Injecting risk behaviours have declined but remain a problem
The level of needle and syringe sharing among PWID has fallen across the UK, but needle and syringe sharing remains a problem, with over 1 in 6 reporting sharing of needles and syringes in the past month.
Changing patterns of psychoactive drug injection remain a concern
In recent years, there has been an increase in the number of “new psychoactive substances” being used in the UK. There is also evidence for an increase in crack injection in England and Wales.
Provision of effective interventions needs to be maintained and optimised
The provision of effective interventions to reduce risk and prevent and treat infections needs to be maintained. These interventions include needle and syringe programmes, opioid substitution treatment and other treatments for drug misuse and dependence. Vaccinations and diagnostic tests for infections need to be routinely and regularly offered to people who inject or have previously injected drugs. Care pathways and treatments should be optimised for those testing positive.