Could Better Syringe Programs Reduce the Rate of Hepatitis C?

Teacher describing how new hepatitis C syringe programs can helpIn Australia, there has been a sizeable reduction in the number of new hepatitis C cases amongst users of injectable narcotics. This new trend was reported in the American Journal of Public Health, but what’s the source of this latest development? Well, health care experts believe that this is the byproduct of improved needle and syringe programs.

Jenny Iverson, a PhD candidate at the Kirby Institute at the University of New South Wales in Sydney worked with a team of colleagues to study the effects that these programs were having. In a recent press release, she noted how this reported decline in the incidence of HCV certainly coincided with the expansion of these syringe and needle programs as well as opioid substitution therapy. The primary goal of these courses are to teach drug users safe practices in order to minimize the spread of viruses like hepatitis C.

She also stated that they are seeing a decline in the number of young people who are choosing to try these types of illicit drugs. However, other reports suggest that the drugs a lot of people are choosing to inject have begun to change, which could be having an impact on the number of new HCV cases being diagnosed.

A Retrospective Study on Hepatitis C

Iverson and her team recently completed a passive retrospective study on 724 people who were all regular drug users, but all had tested negative for HCV antibodies prior to the beginning of the study. Every participant had also taken part in the annual Australian Needle and Syringe Programs Survey regularly from 1995 to 2010 (most had done so consecutively, but some had a 1 year gap where they didn’t take part).

Out of the 724 participants in this hepatitis C clinical trial, the team found HCV seroconversions in 180 of them, which makes for a pooled incidence density of 17 per 100 person-years. The reported incidence density was different each year, with a high of 30.8 per 100 person-years in 2003 and a low of 4 per 100 person-years in 2009. During further analysis, Iverson’s team found that the frequency of injection, types of drugs injected (cocaine, heroin, methamphetamine, etc.), time spent in prison, and place of residence all were independent predictors for HCV seroconversion.

Australia Keeps an Eye Out for HCV and HIV

Lisa Maher, PhD, the head of the viral hepatitis epidemiology and prevention program at the Kirby Institute, was also interviewed for the same press release. She believes that the results of this study help prove the value of Australia’s system set up to keep an eye on the incidence of HCV and HIV among people who inject illicit drugs, a difficult task as hepatitis C is usually asymptomatic. This program has been internationally recognized in recent years, and Maher states that this research certainly supports ongoing investment in this valuable resource for the public health.

In conclusion, Maher stated, “This is the first time in the world this method has been used to estimate hepatitis C incidence and the first report of incidence in a national sample of people who inject drugs. It allows us to assess the uptake and impact of prevention and treatment interventions in this group.”