A comparison between the force of infection estimates for blood-borne viruses in injecting drug user populations across the European Union: a modelling study

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J Viral Hepat. 2008 Nov;15(11):809-16. Epub 2008 Aug 28.

A comparison between the force of infection estimates for blood-borne viruses in

injecting drug user populations across the European Union: a modelling study.

Sutton AJ, Hope VD, Mathei C, Mravcik V, Sebakova H, Vallejo F, Suligoi B,

Brugal MT, Ncube F, Wiessing L, Kretzschmar M.

Ecology and Epidemiology Group, Department of Biological Sciences, University of

Warwick, Coventry, UK.

andrew.sutton@...

A number of studies have been conducted in injecting drug user (IDU) populations

in Europe, in which the prevalence of human immunodeficiency virus (HIV),

hepatitis B virus (HBV) and hepatitis C virus (HCV) was measured together with

demographic and epidemiological information such as age and the age at first

injection. A measure of the risk of becoming infected is the force of infection

(FOI), defined as the per capita rate at which susceptible individuals acquire

infection. The objective of this study was to estimate the FOI and its

heterogeneity for HBV, HCV and HIV (where available) for IDU populations in a

number of countries in Europe. Data were obtained from five countries: Belgium,

the United Kingdom, Spain and Italy, and the Czech Republic, which provided two

data sets. The model describes the prevalence of infection as a function of the

FOI that may vary over time or duration of IDU. In addition to this, if two or

more infections were being considered then a parameter describing the potential

heterogeneity of the FOI within the IDU population was also estimated. The

results here add to the growing evidence that new initiates to injecting are at

an increased risk of blood-borne viral infection compared with more experienced

IDUs. In addition, there is evidence of individual heterogeneity of FOI

estimates within the overall IDU populations. This suggests that different

proportions of individuals in each population are at increased risk of infection

compared with the rest of the population. Future interventions should identify

and target these individuals. Moreover, changes over time in individual

heterogeneity estimates of IDU populations may provide an indicator for

measuring intervention impacts.

PMID: 18761605 [PubMed - indexed for MEDLINE]