Cost-effective tools to reduce the spread of the hepatitis C virus in people who inject drugs

By Clare Thomas, Matt Hickman, Peter Vickerman, Adam Trickey, Zoe Ward, Joanna Kesten, Sabi Redwood, Darren Bagnall, Sedona Sweeney, Elizabeth Hancock, Andrew Preston, Deborah Hussey, Rachel Ayres & Jane Neale

Summary

There are an estimated 71 million people worldwide living with the blood borne virus (BBV) hepatitis C. Most new infections in the UK and other developed countries are amongst people who inject drugs. Therefore, initiatives to reduce the spread of the hepatitis C virus (HCV) in this population are needed.

This multi-method research project has strengthened the evidence base for World Health Organization (WHO) and UK National Institute for Health and Care Excellence (NICE) recommendations that aim to eliminate HCV amongst people who inject drugs. It evaluated the clinical benefits and cost-effectiveness of needle and syringe programmes (NSP) that provide access to sterile injecting equipment for people who inject drugs and the use of low dead space syringes in reducing the spread of the HCV.

Low dead space syringes can reduce the spread of BBVs when injecting equipment is shared. This is because less blood is left in the low dead space syringe after use, compared to syringes with a higher dead space. Whilst low dead space syringes with fixed needles have been available for many years, some people who inject prefer to use detachable needles, and these syringes have a much greater dead space. Recently, detachable low dead space needles have been developed, giving more options to people who inject drugs.

This research project worked with NSP workers in Bristol and Bath and people who inject drugs to explore their views about the acceptability of detachable low dead space syringes in order to inform initiatives aimed at increasing their use. Co-designed materials were produced with people who inject drugs in order to promote the use of needle and syringe programmes and low dead space syringes amongst key populations.