UC San Francisco researchers are recommending a combination of six comprehensive measures to prevent the spread of hepatitis C, in an effort to address the more than 31,000 young people they estimate may be newly infected with the virus each year in the United States due to injection-drug use.
The measures, which stem from a 16-year UCSF research project with injection-drug users, known as the "U Find Out" or UFO Study, build upon the successes of clean syringe programs and similar efforts, while recommending greater focus on the social issues behind drug use and further integration of the multiple approaches to combating hepatitis C.
In February, the U.S. Department of Health and Human Services (HHS) noted the rising epidemic of hepatitis C virus among young people aged 15-30 who inject drugs, calling attention to an increasingly serious issue nationwide. While data on hepatitis C are limited, the HHS estimates that as many as 3.9 million people in the United States are living with a chronic form of the disease, which the researchers said is at least 10 times more infectious than HIV. In 2007, the number of U.S. deaths associated with hepatitis C surpassed those from HIV for the first time.
"Based on our UFO Study here in San Francisco, we have accumulated data that identify key strategies that, when scaled up, could substantially reduce the rate of new hepatitis C infections among young people who inject drugs," said the study's lead investigator, Kimberly Page, PhD, MPH, a professor in the UCSF Department of Epidemiology and Biostatistics, and in UCSF Global Health Sciences.
The research team examined several data sources to arrive at the new estimate of 31,000 new cases per year and identified six areas where prevention efforts should be focused. Findings appear online July 24, 2013, in a special supplement titled, "Prevention and Management of Hepatitis C Virus among People Who Inject Drugs: Moving the Agenda Forward," in the journal Clinical Infectious Diseases. The publication coincides withWorld Hepatitis Week, July 21-28, 2013.
First, while syringe-exchange programs have long been recognized as an absolutely essential element in disease prevention, giving injectors access to clean needles and syringes, the UFO Studyteam discovered that up to 40 percent of infections occurred from exposures to shared drug preparation containers, filters, and rinse water.
"The hepatitis C virus lives a long time on surfaces and can easily contaminate various types of injecting equipment, so while expanding needle exchanges throughout the country is essential, one of our critical recommendations is that existing and newly established exchanges provide clean ancillary equipment along with needles and syringes," said Page.