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Evolution of HCV infection incidence among drug users in France


Hépato-Gastro. Volume 19, Number 2, 105-16, Février 2012, Mini-revue

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Author(s) : Damien Lucidarme, Clotilde Duburque, Wissam Yassine, Philippe Bulois, Bernard Filoche

Summary : Over the last forty years, the dynamics of hepatitis C virus (HCV) infection among drug users has been affected by the illicit drug market, the health environment including the devastating impact of the HIV/AIDS epidemic which erupted in the 1980s, and the diffusion of substitution treatment beginning in 1995. The incidence of HCV infection among drug users in France reached a peak in the late 1980s or early 1990s after a long period of epidemic expansion. Implementation of a risk reduction policy enabled a very significant reduction in the incidence of HCV infection among drug users over the last twenty years, which represents now 10 to 15% of the 1990 estimate. The main consequences of this policy would be to have contributed to a reduction in the number of injectors and to favour alternative modalities such as inhalation and smoking, but also to have led users to avoid risk taking when injecting and to discontinue this mode of administration or limit its frequency. Better access to anti-viral treatment for drug users may also have contributed to the decline in HCV infection incidence.

Keywords : HCV, HIV, incidence, prevalence, drug user, France, VHC, virus de l’hépatite C, VIH, virus de l’immuno-déficience humaine, BHD, buprénorphine haut dosage, Caarud, centre d’accueil et d’accompagnement à la réduction des risques pour usagers de drogues, CSST, centre spécialisé de soins aux toxicomanes

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