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STUDY 2005 PDF file 154Kb
Hepatitis C therapy cost-effective for injectors
Two new analyses agree that despite relapse to drug use and imperfect adherence to a demanding medical regime, anti-viral therapy for hepatitis C infection in drug injectors cost-effectively prolongs and improves life.
OFFCUT 2005 PDF file 151Kb
Hepatitis C is spreading more rapidly than was thought
From the early 2000s in Britain there was clear evidence from research and routine monitoring that drug policy was failing to contain hepatitis C infection among injectors, and worrying signs of a trend upwards in HIV infection.
US figures show that testing needle exchange users for hepatitis B and at the same time starting a short course of vaccinations (the UK model) saves lives and thousands of health service dollars, but UK exchanges have lagged behind in offering these services.
Despite the challenges, review confirms that hepatitis C infection can be prevented among injectors, but it takes multi-component strategies with elements such as substitute prescribing to reduce or eliminate drug injection, treatment of infection, and enabling safe injection practices by providing sterile injecting equipment and behaviour-change counselling.
Trends in hepatitis C infection among recent initiates to drug injecting in England between 2004 (when a national action plan was launched) and 2008 indicate the importance of reinvigorating and improving the coverage of harm reduction measures such as needle exchange and substitute prescribing.
Among the messages of this simulation model for the UK and other countries is the resilience of hepatitis C in the face of considerable investment in methadone and needle exchange services, that these have nevertheless helped and need to be maintained and if possible expanded, but also that further measures are required to substantially curtail the virus.
A combination of needle exchange, methadone maintenance and a shift away from injecting meant that between 2008 and 2012, 1000 fewer Scottish injectors had to face chronic infection with the potentially deadly hepatitis C virus.
STUDY 2012 HTM file
Association between harm reduction intervention uptake and recent hepatitis C infection among people who inject drugs attending sites that provide sterile injecting equipment in Scotland
National survey of injectors attending services supplying injecting equipment suggests methadone maintenance plus an abundant supply of needles and syringes help protect Scottish injectors from infection by hepatitis C.
In the UK context, this study’s findings imply that to prevent new cases it is best to focus expensive new treatments for hepatitis C infection on injectors who infrequently share their injecting equipment – patients most likely to be found and recruited via needle exchanges and addiction treatment services.
HOT TOPIC 2017 HTM file
Hepatitis C ‘giant’ still growing
One of our selection of hot topics – important issues which sometimes generate heated debate. For a time it seemed impossible to reverse the epidemic of injecting-related hepatitis C infection. Now we know that aided by new treatments which clear the infection, it can be done – but will we?
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