Needle-Exchange Programs Limit Spread of Hepatitis C

By Amy Norton

NEW YORK (Reuters Health) Jun 29 - Programs that give drug users clean needles or safer drug substitutes can cut the spread of hepatitis C, a new study suggests.

In the U.S., most of the roughly 18,000 new infections each year occur when drug users share tainted needles or syringes. Studies have found that clean-needle programs reduce needle-sharing and seem to protect against infection with HIV. The same appears true of programs that get addicts into treatment with methadone.

There has been little evidence that these programs help cut the spread of hepatitis C. But the new findings, published online May 25th in Addiction, suggest that needle and opiate-substitution programs can make a difference in hepatitis C risk, according to senior researcher Matthew Hickman at the University of Bristol in the UK.

Combining the results from six previous studies of UK programs, Hickman's team found that drug users with the highest "coverage" from clean-needle programs were about half as likely to acquire HCV infection as other users.

Among users who said they got enough clean needles to cover all of their injections, just under 4% became HCV-positive. That compared with 7% of drug users who didn't get clean needles for all their injections.

Similarly, the rate of new hepatitis C infection was 3% among drug users who were currently taking an opiate substitute (usually oral methadone), versus 7% among those not on treatment.

Drug users participating in both types of programs fared best of all, with a new infection rate of 2%.

"The implication is that hepatitis C transmission can be reduced by opiate substitution therapy and needle and syringe programs, especially their combination," Hickman told Reuters Health in an email.

While the study looked only at UK programs, it's likely the results would be similar in other countries, he said.

The study has its limits. Its findings are based on observational studies and small numbers. The researchers had usable information on 919 program participants across the six study sites, and there were 40 cases of new hepatitis C infection.

Still, Hickman said the study starts to fill a gap in the knowledge of how well injection drug use programs are working.

SOURCE: http://bit.ly/lMvRUW