NAM aidsmap (01.17.2014)
NAM Aidsmap reported on a study showing that a diagnosis of hepatitis C virus (HCV) infection resulted in a reduction in injecting drugs. Injecting drug use is the main method of HIV transmission. In Canada 83 percent of HCV-positive individuals are people who inject drugs (PWID). To prevent HCV transmission, Canada uses harm reduction programs such as needle and syringe exchanges, information on safer injecting practices, and HIV and HCV screening. Researchers in Montreal investigated whether HCV testing had a lasting effect on injecting behaviors and alcohol use among PWIDs.
The researchers used a longitudinal study with 208 adult HCV-negative PWIDs. The majority of participants were male (83 percent) with a mean age of 34 years. Researchers screened participants for HCV every six months, and participants answered questions about their recent injecting behaviors and alcohol use. The researchers also provided post-test counseling and referrals. Mean duration of follow-up was 30 months. One-third of participants were diagnosed with HCV for an incidence rate of 14.4 per 100 person years. HCV-positive participants were significantly more likely than those who remained negative to report injecting opioids and cocaine and sharing syringes in the previous six months. During follow-up, the number of participants who reported sharing syringes decreased to very low levels, regardless of HCV infection status.
A positive HCV test result was associated with significant and lasting decrease in reporting injecting cocaine and heroin. Every additional three months of follow-up was associated with a 10 percent decrease in reporting injecting behaviors. Injecting heroin and cocaine were unchanged for participants who tested HCV negative. The researchers concluded that receiving the HCV-positive test result was responsible for the decrease in risk among PWIDs. HCV screening did not appear to affect alcohol use. The researches view the continued use of alcohol as a cause for concern as alcohol use is associated with acceleration of HCV disease progression.
The full report, “Sustained Drug Use Changes Following Hepatitis C Screening and Counseling Among Recently Infected Persons who Inject Drugs, was published online in the Journal of Clinical Infectious Diseases (2013; doi: 10.1093/cid/cit938).