August 8, 2013

Doing the maths to cut Hepatitis C in injecting drug users

blogger_HCVHepatitis C is a blood borne virus and a major cause of liver disease and liver cancer. Around 150m people globally are estimated to suffer from the virus and in the UK, and many developed countries, people who inject drugs are at the biggest risk.

Of the 150,000 people with chronic hepatitis C in the UK, over 85% are current or former intravenous drug users. And about 40% of people who inject drugs are chronically infected with Hep C, compared to only 1% infected with HIV.

To prevent Hep C and its related liver disease, it’s clear we need to manage and prevent the disease among people who inject drugs.

Traditional harm reduction interventions

Currently, programmes to prevent Hep C transmission among people who inject drugs generally centre on needle and syringe schemes, which increases use of sterile equipment and lowers the risk of needle sharing, and opiate substitution treatment, which can reduce how often someone injects.

In the UK there has been considerable investment in both harm reduction measures – and it’s estimated that about half of injecting drug users may be on one intervention or the other. And evidence on the effectiveness of these strategies suggest that either can reduce Hep C transmission by about 50%, but combining them could reduce Hep C risk by 80%.

Our previous modelling work suggests that scaling up traditional harm reduction interventions can reduce the Hep C burden among people who inject drugs. For example, if current harm reduction measures] were removed, then over 80% of these drug users could have been chronically infected with Hep C, instead of the 40% seen today.

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