Blood-borne infections in Dublin's opiate users

Background Injecting drug users are at high risk of acquiring blood-borne i nfections. Ireland has had a harm reduction policy of methadone maintenance and needle exchange since 1992. Aim To estimate prevalence of hepatitis B, hepatitis C and HIV infection an d appropriate uptake of hepatitis B vaccine in methadone attendees and to m ake recommendations for a simple record-based surveillance system. Method Retrospective study of 138 client records for evidence of laboratory tests or test results for bloodborne viruses and appropriate immunisation against hepatitis B. Results A total of 60% of clients had evidence of one or more laboratory te sts in their notes. Of those tested for individual viruses, 5.1% were posit ive for hepatitis B surface antigen, 78.8% had antibodies to hepatitis C an d 16.7% were HIV positive. Nearly two-thirds of clients had no evidence of vaccination or information on prior immunity in their records. Conclusions A standardised written protocol for screening for blood-borne v iruses and for immunisation against hepatitis B in methadone service attend ees was clearly needed, and was subsequently introduced by the Eastern Regi on Health Authority.