Search

Background and aims: The aims of this study were, in people in treatment for drug use in Funen, Denmark, to: (1) assess prevalence of hepatitis C virus (HCV) test uptake and prevalence of HCV; (2) identify predictors of test update and HCV infection; and (3) characterize changes between 1996 and 2015 in test uptake, HCV prevalence and drug use. Design Cohort study linking the Danish National Registry on Drug Users in Treatment to the regional hepatitis test registry and the Danish Death Certificate Registry, thus combining longitudinal data on drug use with data on HCV testing and results. Setting and participants: People recorded as having received treatment for drug use between 1996 and 2015 (n = 5483) in Funen, Denmark. In the cohort, 24.8% were female, median age 23 years [interquartile range (IQR) = 20–32] at entry and 50% had self‐reported injecting or had received opiate substitution therapy (OST). Measurements The main outcomes were the test for HCV ever and latest HCV‐RNA being positive. The main predictors were for test and infection investigated; ever receiving OST, self‐reported injecting, age at entry and connection to treatment centre offering outreach hepatitis care. Findings HCV test uptake was 52% and prevalence of current HCV‐RNA+ was 21% in people alive at the end of follow‐up. Positive predictors of having undergone HCV testing were: receiving OST [odds ratio (OR) = 3.7; 95% confidence interval (CI) = 3.2–4.5], self‐reported injecting (OR = 2.3; 95% CI = 2.0–2.7), female gender (OR = 1.7; 95% CI = 1.4–1.9) and having been connected to centres with outreach hepatitis care (OR = 1.4; 95% CI = 1.2–1.7). In people alive, HCV‐RNA+ prevalence was 31% if ever on OST or self‐reported injecting. Among HCV‐infected people, 69% were in drug use treatment at end of follow‐up. For participants entering the cohort after 2010, only 5% reported opiates as main drug of use and 17% had experience of injecting. Conclusion: Among Danish people in treatment for drug use from 1996 to 2015, receiving opiate substitution therapy had the largest associating to being tested for hepatitis C virus. As opiate use is declining, adapting test strategies will be necessary. [ABSTRACT FROM AUTHOR]

Background and aims The municipality of Amsterdam implemented a new alcohol policy allowing alcohol outlets in two of the five nightlife areas to extend their closing times from 1 April 2009 onwards. We investigated how levels and trends of alcohol-related injuries changed after implementation of this alcohol policy, by comparing areas with extended closing times to those without. Design A controlled before-and-after evaluation to compare changes in alcohol-related injuries between intervention and control areas. Setting Central district of Amsterdam, The Netherlands. Participants Alcohol-related ambulance attendances for control and intervention areas between 1 April 2006 and 1 April 2009 (respectively, n = 544 and n = 499) and between 1 April 2009 and 1 April 2011 (respectively, n = 357 and n = 480). Measurements Alcohol-related injuries were defined as ambulance attendances for people who suffered from direct or indirect consequences of alcohol consumption. Injuries were counted per month in two intervention and three control nightlife areas. We used Poisson regression to assess changes in injuries. Findings After 1 April 2009, intervention areas showed a larger change in the level of alcohol-related injuries than control areas [incidence rate ratio 1.34, 95% confidence interval (CI) = 1.12, 1.61], but trends remained stable in all areas. This increase was only statistically significant for the following subgroups: 2.00-5.59 a.m., weekend days, men, individuals aged 25-34 years, and people transported to a hospital. However, the increase did not differ between subgroups with statistical significance. Conclusions A 1-hour extension of alcohol outlet closing times in some of Amsterdam's nightlife areas was associated with 34% more alcohol-related injuries. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims To determine the effect of age, sex and cohort on the prevalence and genetic architecture of adolescent alcohol use (AAU). Design Survey study in participants registered with the Netherlands Twin Register. Setting Twins from the general population. Participants Two cohorts (data collected in 1993 and 2005-08) of twins aged 13-15, 16-17 and 18-21 years. In 1993 and 2005-08 a total of 3269 and 8207 twins, respectively, took part. Measurements Survey data on initiation and frequency of alcohol use and quantity of alcohol consumed. Findings The prevalence of alcohol initiation increased between 1993 and 2005-08 for both males and females. The largest difference was for girls observed at ages 13-15, where the prevalence increased from 59.5% to 72.4%. We also found increases in prevalence across cohorts for quantity of alcohol consumed and non-significant increases for frequency of alcohol use. From age 16 onwards, boys drank more frequently and larger quantities than girls. Genetic model fitting revealed that the genetic architecture of AAU did not differ between birth cohorts, nor were there differences between boys and girls. Genetic factors explained between 21% and 55% of individual differences in alcohol measures throughout adolescence. Shared environment explained between 17% and 64% of variance in alcohol use, across different age groups and alcohol measures. Conclusions In the Netherlands, the prevalence of alcohol initiation, frequency and quantity has increased in adolescents over a 15-year period, but there are no changes in the genetic architecture of adolescent alcohol use. [ABSTRACT FROM AUTHOR]