Diagnostic hepatitis C testing of people in treatment for substance use disorders in Belgium between 2011 and 2014 : a cross-sectional study.

BACKGROUND: Hepatitis C prevalence figures for people who use drugs in Belgium are scarce, and particularly for people who inject drugs. The current study refines the existing HCV estimates by focussing on diagnostic HCV testing practices for this population at risk. METHODS: The analysis is the result of a descriptive crosssectional study, based on data extracted from the linkage between a database of people in treatment for substance use disorders in Belgium and a database of the Belgian health insurance companies. By using national nomenclature codes for HCV tests, the number of people in treatment for substance use disorders who were tested on HCV, were estimated. RESULTS: 18,880 out of 30,905 patients (61.1%) in treatment for substance use disorders between 2011 and 2014 have been screened at least once for HCV between 2008 and 2015. 58.0% of those who had never injected and 59.1% of those with an unknown injecting status were tested for HCV, compared to 86.5% of the patients who had recently injected and 84.5% of those who had ever injected. 36.8% of the people who had recently injected were tested for HCV RNA. CONCLUSIONS: This study supports the need of a continued effort of health care providers to identify people infected with HCV. For a population at risk such as people who use drugs, regular screening is needed to reach the goal set by WHO of near viral elimination of HCV by 2030.

Combining attenuated total reflectance- infrared spectroscopy and chemometrics for the identification and the dosage estimation of MDMA tablets.

The principal objective of the Belgian Early Warning System on drugs (BEWSD) of the Reitox national focal point is to collect and disseminate information on the appearance of drugs circulating on the local drug market. To this end, one of the actions of BEWSD is to annually collect substances that are circulating on the Belgian summer festivals. Every year a high number of seized samples is collected and submitted to qualitative and quantitative analysis. The goal is twofold: next to the monitoring of the drug market, a surveillance on the quality of drugs is established with main focus on the evolution of MDMA dosages in ecstasy as well as the emergence of new psychoactive substances (NPS). The presented paper focusses on the characterization of ecstasy tablets, seized at summer festivals in the seasons 2016 and 2017. Samples were classically analysed with GC-MS and UV spectroscopy, representing a certain cost and time for analysis. In this paper, an approach is presented based on infrared spectroscopy to first differentiate ecstasy from other party drugs and further quantify MDMA in the tablets. To this end, a comparison was done between NIR and Mid-IR spectroscopy in combination with partial least squares-discriminant analysis (PLS-DA) and -regression (PLS). For the differentiation between MDMA positive and negative tablets, the best results were obtained by NIR and PLS-DA and resulted in a correct classification rate of 96% for an external test set. In addition, for the quantification of MDMA, the best results were also obtained with a PLS model based on NIR spectra. A RMSEP for the external test set of 3.86 was obtained and an R2 value between real and predicted values of 0.88. This means that for the dosage MDMA per tablet, when taking into account the range of masses of the tablets in our sample set, the error varies between 8 mg for low mass tablets and 27.8 mg for high mass tablets. These are acceptable values for a first estimation and give a first indication of the risk the tablet may represent. The presented approach will be of use for on-site analysis. Moreover, when applied in a laboratory environment, it will reduce the workload for the analysis of MDMA tablets and thus liberating resources.