Syringe exchange and risk of infection with hepatitis B and C viruses

Holly Hagan, James P. McGough, Hanne Thiede, Noel S. Weiss, Sharon Hopkins, E. Russell Alexander

Research output: Contribution to journalArticle

Abstract

The authors utilized a cohort study among Seattle injection drug users (IDUs) to assess whether participation in a syringe exchange program was associated with incidence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. Susceptible IDU subjects (187 seronegative for antibody to HCV, and 460 seronegative for core antibody to HBV) were identified in drug treatment, corrections, and social service agencies from June 1994 to January 1996, and followed for seroconversion one year later. The subjects included in the analysis were Seattle-King County (Washington State) area IDUs enrolled in a larger multipurpose cohort study, the Risk Activity Variables, Epidemiology, and Network Study (RAVEN Study). There were 39 HCV infections (20.9/100/year) and 46 HBV infections (10.0/100/year). There was no apparent protective effect of syringe exchange against HBV (former exchange users, relative risk (RR) = 0.68, 95% confidence interval (CI) 0.2-2.5; sporadic exchange users, RR = 2.4, 95% CI 0.9-6.5; regular users, RR - 1.81, 95% CI 0.7-4.8; vs. RR = 1.0 for nonusers of the exchange; adjusted for daily drug injection). Neither did the exchange protect against HCV infection (sporadic users, RR = 2.6, 95% CI 0.8-8.5; regular users, RR = 1.3, 95% CI 0.8-2.2; vs. RR = 1.0 for nonusers; adjusted for recent onset of injection and syringe sharing prior to enrollment). While it is possible that uncontrolled confounding or other bias obscured a true beneficial impact of exchange use, these data suggest that no such benefit occurred during the period of the study.

Original languageEnglish (US)
Pages (from-to)203-213
Number of pages11
JournalAmerican Journal of Epidemiology
Volume149
Issue number3
StatePublished - Feb 1 1999

Fingerprint

Syringes
Hepatitis B virus
Hepacivirus
Virus Diseases
Infection
Confidence Intervals
Drug Users
Injections
Cohort Studies
Needle-Exchange Programs
Needle Sharing
Hepatitis B Antibodies
Hepatitis C Antibodies
Social Work
Pharmaceutical Preparations
Epidemiology
Incidence

Keywords

  • Hepatitis B
  • Hepatitis C
  • Incidence
  • Injection drug users
  • Needle sharing
  • Needle-exchange programs
  • Prevention

ASJC Scopus subject areas

  • Epidemiology

Cite this

Hagan, H., McGough, J. P., Thiede, H., Weiss, N. S., Hopkins, S., & Alexander, E. R. (1999). Syringe exchange and risk of infection with hepatitis B and C viruses. American Journal of Epidemiology, 149(3), 203-213.

Syringe exchange and risk of infection with hepatitis B and C viruses. / Hagan, Holly; McGough, James P.; Thiede, Hanne; Weiss, Noel S.; Hopkins, Sharon; Alexander, E. Russell.

In: American Journal of Epidemiology, Vol. 149, No. 3, 01.02.1999, p. 203-213.

Research output: Contribution to journalArticle

Hagan, H, McGough, JP, Thiede, H, Weiss, NS, Hopkins, S & Alexander, ER 1999, 'Syringe exchange and risk of infection with hepatitis B and C viruses', American Journal of Epidemiology, vol. 149, no. 3, pp. 203-213.
Hagan H, McGough JP, Thiede H, Weiss NS, Hopkins S, Alexander ER. Syringe exchange and risk of infection with hepatitis B and C viruses. American Journal of Epidemiology. 1999 Feb 1;149(3):203-213.
Hagan, Holly ; McGough, James P. ; Thiede, Hanne ; Weiss, Noel S. ; Hopkins, Sharon ; Alexander, E. Russell. / Syringe exchange and risk of infection with hepatitis B and C viruses. In: American Journal of Epidemiology. 1999 ; Vol. 149, No. 3. pp. 203-213.
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abstract = "The authors utilized a cohort study among Seattle injection drug users (IDUs) to assess whether participation in a syringe exchange program was associated with incidence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. Susceptible IDU subjects (187 seronegative for antibody to HCV, and 460 seronegative for core antibody to HBV) were identified in drug treatment, corrections, and social service agencies from June 1994 to January 1996, and followed for seroconversion one year later. The subjects included in the analysis were Seattle-King County (Washington State) area IDUs enrolled in a larger multipurpose cohort study, the Risk Activity Variables, Epidemiology, and Network Study (RAVEN Study). There were 39 HCV infections (20.9/100/year) and 46 HBV infections (10.0/100/year). There was no apparent protective effect of syringe exchange against HBV (former exchange users, relative risk (RR) = 0.68, 95{\%} confidence interval (CI) 0.2-2.5; sporadic exchange users, RR = 2.4, 95{\%} CI 0.9-6.5; regular users, RR - 1.81, 95{\%} CI 0.7-4.8; vs. RR = 1.0 for nonusers of the exchange; adjusted for daily drug injection). Neither did the exchange protect against HCV infection (sporadic users, RR = 2.6, 95{\%} CI 0.8-8.5; regular users, RR = 1.3, 95{\%} CI 0.8-2.2; vs. RR = 1.0 for nonusers; adjusted for recent onset of injection and syringe sharing prior to enrollment). While it is possible that uncontrolled confounding or other bias obscured a true beneficial impact of exchange use, these data suggest that no such benefit occurred during the period of the study.",
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