About 20% of people in England who inject drugs do not know they have hepatitis C infections, according to Public Health England (PHE).
In 2013, 90% of the 13,570 people diagnosed with hepatitis C had injected drugs such as heroin, cocaine and amphetamines, it said.
Two out of five drug users who used needles had the infection and half of these did not know it, said PHE.
The viral infection can lead to liver cancer, which can be fatal.
It can be spread through the blood of an infected person, which is why drug users sharing needles are at risk. More than 200,000 people in the UK currently have the infection.
PHE said early diagnosis was key to prevent the disease being spread and called for interventions to flag up infections earlier.
Blood spot testingDr Vivian Hope, at the organisation, said increasing the diagnosis rate would help reduce the high level of infection he was seeing among people who injected drugs.
He added: "Obtaining blood from people living with hepatitis C who inject drugs can be difficult due to poor venous access.
"Dry blood spot testing is an alternative method that avoids puncturing veins - which has been proven to be reliable and simple, and acceptable to both people who inject drugs and drug service staff."
Dr Hope said using the new testing method had started to help diagnose more cases of hepatitis C.
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