Skip to main content

Bloodborne virus infections among drug users in Ireland: a retrospective cross-sectional survey of screening, prevalence, incidence and hepatitis B immunisation uptake



Injecting drug users are at high-risk of bloodborne virus infections including hepatitis C (HCV), hepatitis B (HBV) and HIV.


To document screening for and immunisation against bloodborne viruses and to determine the known prevalence and incidence of these infections.


A cross-sectional survey of clients attending 21 specialist addiction treatment clinics in one health board area in greater Dublin. Data collected on demographic characteristics, serology for HCV, HBV and HIV and immunisation against HBV.


A total of 316 (88%) had been tested for anti-HCV antibody, 244 (68%) had been tested for anti hepatitis B core antibody (anti-HBc), 299 (84%) had been tested for hepatitis B surface antigen (HBsAg) and 307 (86%) had been tested for anti-HIV antibody.The prevalence of anti-HCV, anti-HBc, HBsAg, and anti-HIV were: 66%, 17%, 2% and 11% respectively. The incidence of HCV, HBV and HIV infections were: 24.5, 9.0 and 3.4 per hundred person years respectively. Eighty-one per cent of those in whom it was indicated, had started a targeted HBV immunisation programme in the clinics.


The proportion of clients screened for HCV, HBV and HIV infection has increased since the introduction of a screening protocol in 1998. Targeted vaccination for opiate users against hepatitis B is more successful than previously shown in Ireland. The prevalence and incidence of bloodborne viruses remains high among opiate users attending addiction treatment services, despite an increase in availability of harm reduction interventions.

This is a preview of subscription content, access via your institution.


  1. Bolumar F, Hernandez-Aguado I., Ferrer L et al. Prevalence of antibodies to Hepatitis C in a population of intravenous drug users in Valencia, Spain, 1990–2.Int J Epidemiol 1996: 25: 204–209.

    Article  CAS  PubMed  Google Scholar 

  2. Levine O, Vlahov D, Nelson K. Epidemiology of hepatitis B viral infections among drug users: seroprevalence, risk factors and viral interactions.Epidemiol Rev 1999: 16: 418–436.

    Google Scholar 

  3. Madden P, Lamagni T, Hope V. The HIV epidemic in injecting drug users.Commun Dis Rep 1997: 7: 128–130.

    Google Scholar 

  4. Brettle R. HIV and harm reduction for injecting drug users.AIDS 1991: 5: 125–136.

    Article  CAS  PubMed  Google Scholar 

  5. Government Strategy to prevent drug misuse. Dublin: Department of Health (Ireland), 1991.

  6. Smyth R, Keenan E, O’Connor J. Bloodborne viral infection in Irish injecting drug users.Addiction 1998: 93: 1649–1656.

    Article  CAS  PubMed  Google Scholar 

  7. Fitzgerald M, Barry J, O’Sullivan P, Thornton L. Bloodborne virus infections in Dublin’s opiate users.Ir J Med Sci 2001; 170:32–34.

    Article  CAS  PubMed  Google Scholar 

  8. Allwright S, Bradley F, Long J, Barry J, Thornton L, Parry J. Prevalence of antibodies to hepatitis B, hepatitis C and HIV among Irish prisoners: results of a national crosssectional survey,BMJ 2001; 321: 78–82.

    Article  Google Scholar 

  9. Smyth B, Keenan E, O’Connor J. Evaluation of the impact of Dublin’s expanded harm reduction programmes on the prevalence of hepatitis C among injecting drug users with short injectinghistories. J Epidemiol Community Health 1999: 53: 434–435.

    Article  CAS  Google Scholar 

  10. Smyth B, O’Connor J, Barry J, Keenan E. Retrospective cohort study examining incidence of HIV and hepatitis C among injecting drug users in Dublin.J Epidemiol Community Health 2003: 57: 310–311.

    Article  CAS  PubMed  Google Scholar 

  11. Introduction of hepatitis B vaccine into childhood immunization services: Management guidelines including information for health workers and parents Geneva, World Health Organization (Department of vaccines and biologicals), 2001.

  12. Immunisation guidelines for Ireland: National Immunisation Committee, Royal College of Physicians of Ireland, 2002.

  13. Mezzelani P, Venturini L, Turrina G, Lugoboni F, Des Jarlais D. High compliance with a hepatitis B virus vaccination programme among intravenous drug users.J Infect Dis 1991, 163(923).

    CAS  PubMed  Google Scholar 

  14. Lamagni T, Davison K, Hope V et al. Poor hepatitis B vaccine coverage in injecting drug users: England 1995 and 1996.Commun Dis Public Health 1999: 2: 174–177.

    CAS  PubMed  Google Scholar 

  15. Crofts N, Nigro L, Oman K, Stevenson E, Sherman J. Methadone maintenance and hepatitis C virus infection among injecting drug users.Addiction 1997; 92(8): 999–1005.

    CAS  PubMed  Google Scholar 

  16. Van Beek I, Dwyer R, Dore G, Luo K, Kaldor J. Infection with HIV and hepatitis C virus infection among injecting drug users in a prevention setting: retrospective cohort study.BMJ 1998: 317: 433–437.

    PubMed  Google Scholar 

  17. Smyth B, Barry J, Keenan E. Syringe borrowing persists despite harm reduction interventions.Addiction 2001: 96: 717–727.

    Article  CAS  PubMed  Google Scholar 

  18. Census 96: Principal demographic results. Dublin: Stationery Offic, 1997.

  19. Comiskey C. Estimating the prevalence of opiate drug use in Dublin, Ireland during 1996. Report submitted to the Department of Health.Department of Health. Dublin, 1998.

    Google Scholar 

  20. National Drug Treatment Reporting System (Statistical Bulletin: National Data 1997 and 1998). Dublin, Drug Misuse Research Division (The Health Research Board), 2000.

  21. Garfein R, Doherty M, Monterosso E, Thomas D, Nelson K, Vlahov D. Prevalence and incidence of hepatitis C virus infection among young adult injection drug users.Journal of Acquired Immune Deficiency Syndrome and Human Retrovirology 1998; 18(Suppiement 1): 11–19.

    Google Scholar 

  22. Stark K, Bienzle U, Vonk R. History of syringe sharing in prison and risk of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus among injecting drug users in Berlin.Int J Epidemiol 1997; 26: 1359–1366.

    Article  CAS  PubMed  Google Scholar 

  23. Grando-Lemaire V, Goisset P, Sorge F et al. [Hepatitis C virus screening in drug users in an addiction out-patient unit].Gastroenterol Clin Biol 2002; 26(12):1091–6.

    PubMed  Google Scholar 

  24. Peat M, Budd J, Burns S, Robertson R. Audit of bloodborne virus infections in injecting drug users in general practice.Commun Dis Public Health 2000; 3(4): 244–246.

    CAS  PubMed  Google Scholar 

  25. Smyth B, McMahon J, O’Connor J, Ryan J. Knowledge regarding hepatitis C among injecting drug users.Drugs Education Prevention and Policy 1999:6:256–264.

    Google Scholar 

  26. Cook P, McVeigh J, Syed O, Mutton K, Bellis M. Predictors of hepatitis B and C infection in injecting drug users both in and out of treatment.Addiction 2001:96:1787–1797.

    Article  CAS  PubMed  Google Scholar 

  27. Clarke S, Keenan E, Bergin C, Lyons F, Hopkins S, Mulcahy F. The changing epidemiology of HIV infection in injecting drug users in Dublin, Ireland,HIV Med 2001: 2: 236–240.

    Article  CAS  PubMed  Google Scholar 

  28. Rezza G, Sagliocca L, Zaccarelli M, Nespoli M, Siconolfi M, Baldassarre C. Incidence rate and risk factors for HCV seroconversion among injecting drug users in an area with low HIV seroprevalence.Scand J Infect Dis 1996; 28(1): 27–9.

    Article  CAS  PubMed  Google Scholar 

  29. Baker A, Kochan N, Dixon J, Wodak A, Heather N. HIV risk-taking behaviour among injecting drug users currently, previously and never enrolled in methadone treatment.Addiction 1995: 90(4): 545–54.

    Article  CAS  PubMed  Google Scholar 

  30. Rumi M, Colombo M, Romeo R et al. Suboptimal response to hepatitis B vaccine in drug users.Arch Intern Med 1991: 151: 574–578.

    Article  CAS  PubMed  Google Scholar 

  31. Quaglio G, Talamini G, Lugoboni F et al. Compliance with hepatitis B vaccination in 1175 heroin users and risk factors associated with lack of vaccine response.Addiction 2002: 97: 985–992.

    Article  PubMed  Google Scholar 

  32. Keating S. Vaccination guidelines for patients attending the ERHA drug treatment clinics. Dublin, Eastern Regional Health Authority, 2000.

    Google Scholar 

Download references

Author information

Authors and Affiliations


Rights and permissions

Reprints and Permissions

About this article

Cite this article

Grogan, L., Tiernan, M., Geogeghan, N. et al. Bloodborne virus infections among drug users in Ireland: a retrospective cross-sectional survey of screening, prevalence, incidence and hepatitis B immunisation uptake. Ir J Med Sci 174, 14–20 (2005).

Download citation

  • Issue Date:

  • DOI:


  • Drug User
  • Human Immunodeficiency Virus Infection
  • Harm Reduction
  • Inject Drug User
  • Opiate User