Hepatitis C Rates Remain High Among Drug Users

Hepatitis C Rates Remain High Among Drug Users

There are many negative consequences associated with using injection drugs. One immediate risk of using such drugs is the transmission of a virus by sharing a needle with another user. Both HIV and Hepatitis C are viral infections highly associated with needle-sharing.

Needle exchange programs and substance abuse treatment are measures needed to reduce the number of people sharing needles to inject drugs. The measures have been proven successful in lowering the rates of new cases of HIV, but for Hepatitis C, the rates have not been as significant.

A recent study examining data for the last 20 years shows that a significant decline of HIV infection among injection drug users in Baltimore is attributed to the success of needle exchange programs and substance abuse treatment. However, because Hepatitis C is nearly 10 times more transmissible by a shared needle than HIV, researchers from the Johns Hopkins School of Public Health report that more drastic measures may be necessary.

Led by Shruti H. Mehta, PhD, MPH, the researchers reported their findings in the March 1 issue of the Journal of Infectious Diseases, in which they detail the rapid decline of HIV and less impressive decline of Hepatitis C. Over 20 years, the HIV rates declined from 5.5 per 100 person-years in 1988-89 to zero cases per 100 person-years in 1998 and again in 2005-08.

Though there were reductions found in cases of Hepatitis C, the rates of decline were much less substantial. The rate of 22 per 100 person-years in 1988-89 reduced to 7.8 per 100 person-years in 2005-08. The study noted that the decline appeared to be occurring among younger injection drug users, who had only recently begun injecting drugs.

The researchers expressed concern that the current efforts to reduce the sharing of needles were effective delaying but not preventing Hepatitis C at the population level. To significantly lower rates of Hepatitis C, treatment, prevention and intervention strategies will require extension expansion.

The study was accompanied by an editorial from Jason Grebeley, PhD and Gregory J. Dore, MB, BS, MPH, PhD, of the University of South Wales in Australia. The authors agreed that the prevalence of Hepatitis C is largely due to the ease of transmission when using a contaminated needle. However, they also noted that the current prevention measures are not being utilized adequately to significantly reduce the spread of Hepatitis C.

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