NEEDLE EXCHANGE MAY NOT LOWER HEPATITIS RATES

NEW YORK, Feb 03 (Reuters Health) — A Seattle needle exchange program did
not reduce hepatitis infection rates among participating intravenous drug
users, according to the results of a study published in the February 1st
issue of the American Journal of Epidemiology.

Researchers conclude that "risk factors for (hepatitis) infection such as
syringe-sharing are still practiced by a substantial proportion of
Seattle-area drug injectors.''

Infection with hepatitis B or C viruses can lead to serious, potentially
life-threatening liver disease. Risk factors for these infections include
intravenous drug use and unprotected sex.

The study involved a group of injection drug users in the Seattle-King
County Department of Public Health needle exchange program who tested
negative for either hepatitis B (HBV) or hepatitis C (HCV) infection at
enrollment.

One year later, 21% of 187 subjects were found to be infected with
hepatitis C and 10% of 460 were infected with hepatitis B. Rates of
infection did not differ between injection drug users in the needle
exchange program and those who had never been enrolled in the program.

"There was no apparent protective effect of syringe exchange against HBV,''
say a team of researchers led by Dr. Holly Hagan of the Seattle-King County
Department of Public Health in Washington. "Neither did the exchange
protect against HCV infection.''

The authors note that the needle exchange program studied was located in
"the drug/sex market area where there was a possible concentration of more
compulsive drug users and those who risk exposure (to hepatitis viruses)
from unprotected sex to a greater degree.'' Hagan's team also theorize that
the sharing of other drug-injection equipment could explain the current
findings.

In a statement issued by the Seattle-King County Department of Public
Health, health officials note that the needle exchange program was set up
"primarily to help prevent the spread of HIV in the community.'' They write
that HIV infection rates in Seattle drug injectors "are extremely low, at
fewer than 3 new infections per 1000 injectors per year.''

"The Seattle exchange will continue to serve as a cornerstone of health
promotion and risk reduction activities for drug injectors, offering
sterile injection equipment, HCV and HIV risk reduction education, HBV
vaccination, and referral to drug treatment,'' the public health officials
write.

SOURCE: American Journal of Epidemiology 1999;149:203-213.