Drug Users who Inject are 50 Times More Likely to Get Hepatitis C

NEW YORK CITY, April 8 ???Injection drug users are 50 times more likely to get infected with the hepatitis C virus than drug users who only inhale illicit drugs, according to a study in the new issue of the Journal of Urban Health: Bulletin of The New York Academy of Medicine.

Since most injection drug users (IDUs) begin as non-injection users of heroin, crack or cocaine, preventing this transition into injecting is a critically important step to reducing risk for hepatitis C. It is a step that is not receiving adequate attention, said David Vlahov, Ph.D., Director of the Academy Center for Urban Epidemiologic Studies and a co-author of the study. The new findings are part of a six-article feature in the Journal about hepatitis C.

"The best protection against hepatitis C is to not use drugs. But short of stopping drug use entirely, avoiding injection is probably the simplest and most effective way to substantially reduce hepatitis C risk," Vlahov said. ???While injection of drugs has long been established as a serious health risk, this new information should be used to encourage inhalant users to avoid transition into injection drug use at least, if they are unable to stop drug use entirely.??? Hepatitis C is a blood-borne infection that can cause liver disease, cirrhosis, liver failure and liver cancer. No vaccine exists for this virus. An estimated 60 to 100 percent of IDUs are infected with hepatitis C, compared to an estimated 5 percent of non-injection drug users, past studies show.

The U.S. Public Health Service has recommended that to prevent blood-borne infections like hepatitis C, injection drug users who cannot stop injecting should use only new sterile syringes with every injection, disinfect their injection equipment with bleach after each use, or avoid sharing equipment. But since a heavily drug-dependent person may find it daunting to adhere to these sanitary practices, it is critically important to intervene with IDUs early or before they begin injecting.

The study was led by Academy investigator Crystal Fuller, Ph.D., and was co-authored by Vlahov, Danielle Ompad, Ph.D., Sandro Galea, M.D., M.P.H., Dr. P.H., and Yingfeng Wu, M.A., all of the Academy, as well as by Beryl Koblin, Ph.D., of the New York Blood Center. Researchers conducted extensive street outreach and screening of 683 non-IDUs and 260 IDUs in Harlem and the South Bronx in New York City. Baseline and follow-up visits took place over 12 months and included risk surveys and blood tests for hepatitis C.

The study was funded through the National Institute on Drug Abuse. The Journal of Urban Health is published quarterly for The New York Academy of Medicine. The Academy is a non-profit institution founded in 1847 that is dedicated to enhancing the health of the public through research, education and advocacy, with a particular focus on urban populations, especially the disadvantaged.

Posted on April 8, 2004

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Andrew J. Martin
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The New York Academy of Medicine
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