The Netherlands Drug Situation 2010 - Trimbos-instituut

6 Health correlates and consequences6.1 Drug-related infectious diseasesThe most important drug-related infectious diseases include HIV/ AIDS, and hepatitis Band C. They are transmissible through sexual contact (HIV, hepatitis B) and blood (hepatitisC, HIV and hepatitis B). Infectious diseases associated with poor living conditions(such as hepatitis A and tuberculosis) may also have higher incidence and prevalencerates among drug users. The overall conclusion of the data presented here is that thenumber of new diagnoses of HIV, and hepatitis B and C among injecting drug users islow. However, there are still indications that the number of chronically infected drug users,and thereby the burden of these diseases, is higher, especially for hepatitis C.6.1.1 HIVFor many years, the main source of information in the Netherlands on the prevalence ofHIV and hepatitis B and C has been the (HIV) sentinel surveillance system among (ever)injecting drug users (IDUs) of the National Institute of Public Health and the Environment(RIVM). However, as regards the risk group of drug users, this surveillance system hasbeen discontinued in 2003. For the historical data collected as part of this surveillancesystem we refer to previous National Reports. Despite the discontinuation of the surveillancesystem for IDUs, the RIVM conducted a new serosurvey in the South of the Netherlandsin 2010, in response to an observed increase in HIV prevalence in the street surveysfrom 11% in 1994 to 22% in 1999 among IDUs in this region. The recruitment andsampling methods have changed however, as the 2010 study took place in a prisonpopulation. The results may therefore give an indication but are not comparable with theprevious findings.In this report we will describe the results from four data sources providing information onHIV and hepatitis infections among (injecting) drug users: the national HIV/ AIDS registry,the cross-sectional serosurvey in a prison population the South of the Netherlands,the Amsterdam Cohort Studies among drug users and regular screening data from drugtreatment centres. We do no longer report data from a fifth source, the 8 regional STIcentres form the sexually transmitted infections (STI) sentinel surveillance, as thissource does not report separately on infections in IDUs anymore due to the low numbersobserved.a. The national HIV/ AIDS registration of the HIV Monitoring Foundation (SHM) was appointedby the Dutch Ministry of Health Welfare and Sport as the executive organisationfor the monitoring of HIV in the Netherlands in 2002. This registration contains data onHIV-infected patients who are seen regularly by HIV/ AIDS treating physicians in one ofthe 25 collaborative HIV treatment centres throughout the country. It also includes datafrom a prior project on HIV positive patients treated between 1998 and 2001 (the AIDSTherapy Evaluation Netherlands, or ATHENA, cohort). The longitudinal, anonymous dataare used to monitor changes in the HIV epidemic, the natural history of HIV and the effectsof treatment (www.hiv-monitoring.nl).79