Recovery of Infectious Hepatitis C Virus From Injection Paraphernalia: Implications for Prevention Programs Serving People Who Inject Drugs. (19th August 2017)

• Record Type: Journal Article
• Authors: Heimer, Robert; Binka, Mawuena; Koester, Stephen; Grund, Jean-Paul C; Patel, Amisha; Paintsil, Elijah; Lindenbach, Brett D
• Is Part Of: Journal of infectious diseases. Volume 217:Number 3(2018)
• Page Start: 466
• Page End: 473
• Publication Date: 2017-08-19
• Subjects: harm reduction -- hepatitis C virus -- injection drug use -- drug paraphernalia -- syringes; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jix427
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract : HCV is readily transmitted among people who inject drugs. Contrary to epidemiological findings implicating drug preparation paraphernalia, HCV is more likely transmitted through passage of HCV from a contaminated syringe into a second syringe rather than retention in paraphernalia. Abstract: Background: Controlling hepatitis C virus (HCV) transmission among people who inject drugs (PWID) has focused on preventing sharing syringes and drug preparation paraphernalia, but it is unclear whether HCV incidence linked to sharing paraphernalia reflects contamination of the paraphernalia or syringe-mediated contamination when drugs are shared. Methods: In experiments designed to replicate real-world injection practices when drugs are shared, the residual contents of HCV-contaminated syringes with detachable or fixed needled were passed through the "cookers" and filters used by PWID in preparing drugs for injection and then introduced into a second syringe. All items were tested for the presence of infectious HCV using a chimeric HCV with a luciferase gene. Results: Hepatitis C virus could not be recovered from cookers regardless of input syringe type or cooker design. Recovery was higher when comparing detachable needles to fixed needles for residue in input syringes (73.8% vs 0%), filters (15.4% vs 1.4%), and receptive syringes (93.8% vs 45.7%). Conclusions: Our results, consistent with the hypothesis that sharing paraphernalia does not directly result in HCV transmission but is a surrogate for transmissions resulting from sharing drugs, have important implications for HCV prevention efforts and programs that provide education and safe injection supplies for PWID populations.