Programs May Curb Hepatitis C in Drug Users

Programs that give injection drug users clean needles or safer drug substitutes may help cut their odds of contracting the liver infection hepatitis C, a new study suggests.

The hepatitis C virus is passed through contact with infected blood. Health care workers are particularly vulnerable, as are people who get tattoos in unclean environments. But in the U.S., most of the roughly 18,000 new infections each year occur when people who inject opiates, like heroin, share tainted needles or syringes.

Studies have found that clean-needle programs do reduce needle-sharing, and they seem to curb drug users' risk of infection with HIV, the virus that causes AIDS. The same appears true of programs that get addicts into treatment with opiate "substitutes" like methadone, which is taken orally instead of injected.

But there has been little evidence that these programs help cut the spread of hepatitis C.

A problem with the hepatitis C virus is that it's much easier to transmit than HIV. Even a faint amount of blood on a shared needle, for example, might be enough to infect another person.
But the new findings, published in the journal Addiction, suggest that needle and opiate-substitution programs can make a difference in hepatitis C risk, according to senior researcher Matthew Hickman, a professor of public health at the University of Bristol in the UK.

Combining the results from six previous studies of UK programs, Hickman's team found that drug users with the highest "coverage" from clean-needle programs were about half as likely to contract hepatitis C as other users.

Among users who said they got enough clean needles to cover all of their injections, just under 4 percent tested positive for hepatitis C during the studies, which lasted up to a year. That compared with 7 percent of drug users who didn't get clean needles for all their injections.

Similarly, the rate of new hepatitis C infection was 3 percent among drug users who were currently taking an opiate substitute (usually oral methadone), versus 7 percent among those not on treatment.

Drug users participating in both types of programs fared best of all, with a new infection rate of 2 percent.

"The implication is that hepatitis C transmission can be reduced by opiate substitution therapy and needle and syringe programs, especially their combination," Hickman told Reuters Health in an email.

While the study looked only at UK programs, it's likely the results would be similar in other countries, he said.

The study has its limits. It combined the results of several observational studies, where researchers "observed" groups of injection drug users who chose to use or not use the needle and opiate substitution programs.

Leaving the choice to the individual makes it hard to show that the programs are what caused hepatitis C infection rates to go down. There may be other differences between people who used the programs and those who didn't that would explain the results.

The findings are also based on small numbers, Hickman's team points out. The researchers had usable information on 919 program participants across the six study sites, and there were 40 cases of new hepatitis C infection.

Still, Hickman said the study starts to fill a gap in the knowledge of how well injection drug use programs are working.

In the U.S., new cases of hepatitis C infection have fallen sharply since the 1980s, according to Centers for Disease Control and Prevention. In the early 1990s, doctors found a way to detect the virus in blood, which meant they could make sure it wasn't transmitted in blood transfusions.

But chronic hepatitis C infection, the agency says, remains a major public health problem.

Between 75 and 85 percent of people infected with hepatitis C develop chronic infection, which can eventually cause serious liver diseases like cirrhosis (scarring of the liver) and liver cancer. Hepatitis C presently accounts for about a third of the liver transplants done in the U.S. each year.

An estimated 3.2 million Americans have chronic hepatitis C, about half of whom are unaware of it. (The initial infection most often causes no symptoms.)

There are medications for treating chronic hepatitis C, although they are not effective for everyone and have side effects like fatigue, nausea, headache and sleep problems.

According to Hickman, one question for future studies is whether treating chronic hepatitis C in injection drug users helps reduce transmission.

MILLVILLE AFTERNOON POLICE BEAT INCLUDES School guards assaulted

Two security guards were injured in a fight between two girls at Lakeside Middle School Friday, police said.
Both girls, a 12 –year-old and 13-year-old were charged with aggravated assault on a public employee and disorderly conduct.

Police say during a fight with each other they kicked two security guards.
One guard was taken to the hospital a rescue squad and the other went on her own. The hospital said one of the guards suffered a minor head injury.
The girls were processed and released. Because of their ages, they’re names were not provided by police.

A resident of East Main Street reported Friday someone stole two toys from her yard, a Fisher Price wagon and basketball hoop.

Someone apparently kicked in the door of a house on JFK Boulevard, a person reported Friday. Nothing was taken.

A resident reported Friday a kayak valued at $599 was taken form his Pleasantview Drive property.

A mother reported Friday $224 was stolen from her son’s wallet, which was left in an unsecured locker at Millville Memorial High School between 2:30 and 4:15 p.m.

A resident of Laurel Road reported Saturday he believes a family friend stole jewelry while living at his home between December and April. The jewelry was described as a yellow gold rope necklace with a charm and a gold ring with four birthstones.

Police responded to burglar alarm on East Pine Street on Saturday. A back door was wide open and window broken. It was not clear if heaving winds Saturday damaged the window. The resident said the door may have been blown open.

Surveillance video at Walgreen’s on North High Street captured a man going behind a counter and stealing 15 packs of Newport cigarettes. He was confronted by an employee and fled on mountain bike. The suspect told the employee, “Don’t touch me.”

A purse was stolen from under a drivers seat after a woman parked at 2nd and East Pine streets to go inside a church. She told police the vehicle was not damaged.

A man and woman were charged Sunday with shoplifting from Advance Auto Parts in the 800 block of North 2nd Street. Police say David M. Livingstone, 45, of the 2200 block of South 2nd Street left the store with a Fix a Thread tool and Phyllis Mary Stout, 40, of the same address took a pair of Boot Clamp Pliers. In addition to shoplifting, Stout was charged with possession of drug paraphernalia after police found a glass pipe in her possession.