What are the incidence and the prevalence of HIV among injecting drug users (IDUs)?

In 2015 in Hungary a total number of 271 newly diagnosed HIV positive cases were reported (2014: 271 persons; 2013: 240 persons; 2012: 219 persons). The incidence rate was 27 cases/1 million inhabitants. The transmission route was known in the case of 60% of the registered HIV positive persons among whom two Hungarian citizens belonged to the risk group of IDUs.

Of the 596 injecting drug users tested in the national HIV/HBV/HCV seroprevalence survey coordinated by the National Centre for Epidemiology, 1 man (0.2%) tested positive for HIV. He was in the 25-34 age group injecting in the past four weeks prior to the survey and had been injecting primarily a new psychoactive substance.

EMCDDA – The number of reported HIV cases

EMCDDA – The prevalence of HIV infection among IDUs

What are the incidence and the prevalence of hepatitis B among injecting drug users (IDUs)?

In 2015 43 cases of acute hepatitis B were reported; the incidence rate was 0.4%ooo. The transmission route was known in the case of 12 patients among whom one person belonged to the risk group of injecting drug users.

During the national HIV/HBV/HCV prevalence survey coordinated by the National Centre for Epidemiology, in 2015 13 persons (2.2%) tested positive for the hepatitis B surface antigen among 596 tested IDUs. 12 of the 13 HBV positive persons were also HCV antibody positive at the same time, while in case of one person the HCV result was inconclusive.

EMCDDA – The number of reported hepatitis B cases

 EMCDDA – The prevalence of hepatitis B infection among IDUs

What are the incidence and the prevalence of hepatitis C among injecting drug users (IDUs)?

In 2015 19 cases of acute hepatitis C were reported, the incidence rate was 0.2%ooo. Among the 19 patients, the transmission route was known in the case of 6 patients among whom three persons belonged to the risk group of injecting drug users.

The laboratory tests of the national HIV/HBV/HCV seroprevalence survey coordinated by the National Centre for Epidemiology gave a conclusive result in 559 cases for HCV. Among them 289 persons tested positive for hepatitis C antibodies (49.7%). Among current drug users injecting in the past 4 weeks prior to the survey, 60.3% tested positive for hepatitis C antibodies.

As regards geographic distribution, 193 of the 349 samples from Budapest proved to be hepatitis C positive, which means a 55.3% rate of infection. Outside of Budapest 85 of the 210 persons (40.5%) tested positive for hepatitis C (Kecskemét: 72,7%, Pécs: 66,7%).

Among which injecting drug user (IDU) groups is the hepatitis C prevalence higher?

In 2015 according to the results of the national HIV/HBV/HCV seroprevalence survey coordinated by the National Centre for Epidemiology the difference between the prevalence rates of HCV infection among men and women (52.0% and 42.5%) was not significant. The HCV prevalence rates of men in the 25-34 age group and of men above the age of 34 were in excess of the average prevalence rate. Apart from this it is important to mention that the HCV prevalence of young male IDUs below the age of 25 was 39%.

In terms of years since first injecting hepatitis C infection was the highest among the groups of IDUs who had been injecting for 5-9 years (59.4%) or for more than 9 years (52.2%).

HCV prevalence rate among those primarily injecting stimulants (amphetamine, cocaine or new psychoactive substances) was 56.8%, while it was 39.5% among IDUs injecting primarily opioids.

Among current injecting drug users injecting in the past four weeks prior to the survey the rate of HCV infection was the highest among those who inject new psychoactive substances (78.7%).

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What is the prevalence of needle/syringe and paraphernalia sharing among injecting drug users (IDUs)?

According to the results of the national HIV/HBV/HCV seroprevalence survey coordinated by the National Centre for Epidemiology, 38.9% of current IDUs had shared syringes in the past 4 weeks, while the prevalence of sharing any injecting equipment in the past 4 weeks was 55.7%. If equipment sharing is examined broken down by primary injected substances, it can be said that the prevalence rates are the highest among NPS injectors (syringe sharing: 48,5%; injecting equipment sharing: 67.1%), which in their case is also coupled with high HCV prevalence (78.7%).

What is prevalence of HIV/ HBV/ HCV among imprisoned people?

The prevalence of HIV hepatitis B and C virus infections is higher among prisoners than in the general population. Research carried out in detention facilities indicates that the majority of prisoners tested positive for HCV probably became infected by earlier injecting drug use meanwhile another group could also be identified who probably acquired the infection by sharing needles used for tattooing.

During 2015 a total of 2419 prisoners were tested for HCV, 13.6% of the average prison population. Among them 190 persons (7.9%, 1.1% of the entire prison population) proved to be HCV antibody positive, of these 96 persons were hepatitis C virus carriers as well. 594 prisoners were tested for hepatitis B (3.3% of the prison population), among them 2 HBV positive cases (0.3%) were identified. 750 prisoners were tested for HIV (4.2% of the prison population), and 1 new case (0.1%) was found.

How does the data of Hungary relate to the trends of the European Union?

According to the European Drug Report of the EMCDDA, Hungary is among the countries which have the lowest prevalence regarding HIV. As for hepatitis C, if the national prevalence is considered, Hungary belongs to the countries with moderate levels of hepatitis C prevalence rates.

Comparative European data on the EMCDDA’s website