New cases of HIV among people who inject drugs in Hungary: False alarm or early warning?

Rácz, József; Gyarmathy, V. Anna; Csák, Róbert

doi:10.1016/j.drugpo.2015.05.026

Cited by 14 publications

(15 citation statements)

References 7 publications

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“…New psychoactive substances (NPS) have since about 2010 dominated the injecting drug scene in Hungary as heroin and amphetamines have become increasingly rarely available [ 5 ]. The injecting of NPS is associated with a high number of daily injecting episodes and a high prevalence of syringe sharing and reuse [ 2 ]. The Drug Prevention Foundation (DPA) opened the first needle exchange program (NEP) in Hungary in 1994 using a legal loophole, and by the end of 2014 there were altogether 31 NEPs operating in 21 cities in the country [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, no outbreak investigation or contact tracing followed the discovery of the second case either, even though that PWID HIV case was also detected in the AIDS stage. It seems that Hungarian public health authorities are largely unprepared or maybe even unwilling – as suggested by the government’s moralistic approach towards drug use – to deal with the reality of drug injecting related infectious diseases and related epidemics [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, contact tracing should be a priority, especially because it is a relatively manageable task due to the low HIV prevalence in the country. In general, public health authorities should do the utmost to monitor, detect and deal with infectious diseases in countries where there is evidence of substantial increases in drug injecting and syringe sharing to avoid HIV outbreaks similar to those in Greece and Romania in 2011 and 2012 [ 2 ]. In addition, protocols about post-exposure prophylaxis should not only exist, but health care personnel should be aware of them and be able to implement them.…”

Section: Discussionmentioning

confidence: 99%

“…Although only 28 people who inject drugs (PWIDs) were registered with HIV infection, the situation relating to PWIDs may be a cause for concern. Before 2014, there were two PWID HIV cases who were also men who had sex with men (MSM) who self-reported possibly having become infected in Hungary sexually, but all 21 other infected PWIDs who were not MSM confirmedly contracted HIV abroad [ 2 ]. However, in 2014 one and in 2015 two new cases of HIV were reported among PWIDs who – according to surveillance documentation – were infected in Hungary [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

HIV among people who inject drugs in Hungary

Ortutay¹,

Gyarmathy

Marjanek³

et al. 2017

Infect Dis Poverty

Self Cite

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BackgroundBefore 2014 (the year of closure of the two largest needle exchange programs in Hungary, which halved the number of available syringes in the country despite increased injecting risk practices) no HIV was reportedly acquired in Hungary among people who inject drugs (PWIDs) who were not also men who had sex with other men (MSM). In 2014, one and in 2015 two non-MSM PWIDs were newly diagnosed with HIV who supposedly became infected in Hungary, and both incident HIV cases in 2015 were diagnosed in the AIDS stage. In addition, two new (albeit supposedly imported) non-MSM PWID cases were also registered in the first three quarters of 2016, one of which subsequently was diagnosed with and then died of AIDS. At the same time, the prevalence of HCV doubled among PWIDs (from 24% to 49% in Hungary and from 34% to 61% in Budapest).Case presentationThe case that we discuss in this paper is a male PWID, who was diagnosed with HIV and AIDS in May of 2015 and then died of AIDS the next month. His HIV infection status was detected with delay, and then appeared in the official statistics as an incident PWID HIV case and an incident PWID AIDS case, but not as an incident PWID AIDS death. No contact tracing followed, even though it would have been relatively easy considering the circumstances. To our knowledge, no HIV post-exposure protocol exists in hospitals, in case of HIV exposure due to an eventual needle-stick injury.ConclusionsOur paper draws attention to recently published HIV and AIDS surveillance data, and shows the failure of the system. While sounding the alarm based on three newly detected PWID HIV cases in the past 2 years may be premature, there are definitely serious problems in the HIV detection and tracing system among PWIDs in Hungary.Electronic supplementary materialThe online version of this article (10.1186/s40249-017-0360-9) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

HIV among people who inject drugs in Hungary

Ortutay¹,

Gyarmathy

Marjanek³

et al. 2017

Infect Dis Poverty

Self Cite

View full text Add to dashboard Cite

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“…HIV rates amongst synthetic cathinone injectors appear to be higher than in 'traditional' drug injecting populations, e.g. Mephedrone, MDPV and methylone injectors in San Diego, California (Wagner et al, 2014), in Ireland amongst homeless α-PVP injectors who often reused syringes and shared filters (Giese et al, 2015); English mephedrone injectors (PHE, 2015); and pentedrone injectors in Hungary (Rácz et al, 2016).…”

Section: Injecting Behaviours and Blood-borne Infectionsmentioning

confidence: 99%

Synthetic Cathinones—Prevalence and Motivations for Use

Corkery

Guirguis

Papanti

et al. 2018

Current Topics in Neurotoxicity

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