Low dead space syringes reduce HCV incidence among people who inject drugs
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The use of low dead space syringes was associated with a 76% reduction in the odds of hepatitis C virus infection among people who inject drugs, according to a study of U.K. data.
This study was prompted by the WHO recommending that needle exchange programs offer low dead space syringes (LDSSs) in a bid to reduce [the] incidence of bloodborne viruses,” Adam J. W. Trickey, MSc, BSc, a research fellow at the Bristol Medical School in England, told Healio. “However, there was previously no real-world evidence of these syringes reducing incidence of bloodborne viruses.”
Trickey said previous evidence was based on the large reduction in the amount of blood that would be held in these syringes following their use compared with high dead space syringes.
To assess the association between the use of fixed LDSSs and the risk for recent HCV infection, Trickey and colleagues used data from the Unlinked Anonymous Monitoring survey an annual cross-sectional biobehavioral survey of people who have ever injected psychoactive drugs who were recruited from specialist harm reduction services in England, Wales and Northern Ireland.
According to the study, participants completed a questionnaire about their drug use behaviors and demographics and provided a dried blood spot sample that was tested for HCV antibodies. Participants were included if they reported injecting in the past month, tested antibody-negative and had an RNA test result.
Overall, the study included 1,465 participants. Among them, 63.8% always used fixed LDSSs, 25.5% always used syringes with detachable needles and 10.7% used both. Trickey and colleagues said there were 33 (2.3%) recent primary HCV infections in the group.
The study demonstrated that use of LDSSs was associated with a 76% reduced incidence of HCV infections among participants who inject drugs. There were fewer recent HCV infections among individuals who always used fixed LDSSs (1.3%; 95% CI, 0.7%-2.3%) than individuals using any syringes with detachable needles (3.8%; 95%, CI, 2.5%-5.8%). Additionally, compared with any use of syringes with detachable needles, exclusive use of fixed LDSSs was associated with lower chances of having recent HCV infection (adjusted OR = 0.24; 95% CI, 0.08-0.67).
According to the study, the only other variable associated with recent infection was injecting crack in the past month (aOR = 3.09; 95% CI, 1.24-7.69).
“Usage of syringes with lower dead space is associated with lower incidence of HCV,” Trickey said. “It is important to note that some injectors, such as those that inject into their groin, may prefer to use syringes with longer needles, that are often detachable and have higher dead space. A greater range of needles with lower dead spaces are becoming available to meet this need.”
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