Netherlands National Drug Monitor - Research and Documentation ...

The total number of chronic hepatitis B infections in 2008 was 1,576; For 1,108 cases
the transmission route was known. In only 3 cases (0.3%) was injecting drug use the
most likely transmission route.
• Since 1998, drug users and other risk groups are offered a vaccination against Hepatitis
B. According to data from GGD Nederland, over 15,625 drug users had availed
of this up to September 2009. This group comprises ever and recent injectors as well
as never injectors. Of the total group almost one percent were chronic Hepatitis B
carriers. Almost 11% had ever contracted hepatitis B and were now immune (Marlies
van Dam, personal communication, RIVM).
International Comparison
Data on Hepatitis C are not easily comparable between countries on account of differences
in sources and methods of data collection. The data only give an indication of
the rate of infection. EMCDDA figures indicate that, as in the Netherlands, Hepatitis C
infection occurs very frequently among injecting drug users in the other EU member
states.
• In most countries, a Hepatitis C infection rate of over 40% is found among injecting
drug users. Only three countries (Bulgaria, the Czech Republic and Finland) report
national research results that show a Hepatitis C rate of less than 25% among injecting
drug users; even these percentages constitute a serious health problem (EMCDDA,
2009).
• Studies conducted among young drug users and drug users who only recently started
to inject (less than two years ago), show that Hepatitis C occurs early in their ‘user
career’. This implies that effective preventative measures should be initiated at an
early stage.
• Among European countries, the variation in the rate of Hepatitis B infection is greater
than for hepatitis C. This may possibly be due to factors such as different vaccination
strategies (universal versus risk groups). The most complete data available concern
having previously had a Hepatitis B infection. In 2006, eleven countries reported data
on this; in six of the eleven over 40 percent of injecting drug users had ever been
infected with hepatitis B. These figures indicate that in some countries Hepatitis B is
still very prevalent among injecting drug users. This is a cause for concern, given the
serious consequences of the infection.
High-Risk Behaviour
Since the 1990s there has been a strong decline in the use of borrowed syringes among
injecting drug users. As such, injecting drugs is also less common (see also § 4.3).
• Recent data are lacking however, for most cities and regions. According to the most
recent surveys, between 8% and 30% of injectors sometimes borrow needles or
syringes (Van de Laar & Op de Coul, 2004).
• In recent years there has been a sharp drop in the number of needles and syringes
that are exchanged in needle exchange programmes in Amsterdam and Rotterdam,
although both cities experienced a slight upsurge in 2008.
96 Netherlands National Drug Monitor - NDM Annual Report 2009