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HCV more prevalent and easier to contract than HIV
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Hepatitis
By WENDY COX -- Canadian Press
VANCOUVER (CP) -- Hepatitis C is shockingly easier to contract than HIV
and the traditional ways of fighting the virus that causes AIDS probably
won't make too much of a dent in the hep C infection rate, say
researchers.
The costs to Canada's health-care system and the risk to health-care
workers could be substantial unless more aggressive methods are found to
educate drug users about the risk, say scientists involved in the study.
Their findings were published Monday in the Canadian Medical Association
Journal.
The researchers from the University of British Columbia studied 1,345
drug users from Vancouver's needle-infested downtown eastside between
December 1996 and November 1999.
Almost 40 per cent were HIV positive when they entered the survey and a
further 10 per cent went on to contract the virus over the three years.
But 80 per cent of the users studied had hepatitis
C when the survey began and another 10 per cent went on to contract it.
"It (hepatitis C) seems to be an occupational hazard among people
who inject drugs," said Dr. Mark Tyndall, who is also with the B.C.
Centre for Excellence in HIV/AIDS.
"Amongst those who are actively using, it seems to be very
difficult even among the best-intentioned and the best-informed people
to avoid hepatitis C.
"So, the current strategies we have probably aren't going to work
if people continue to inject drugs."
Hepatitis C is a blood-borne virus that can be spread through sharing
needles, but also through a shared toothbrush or razor.
It can lead to liver cirrhosis
in 20 to 30 per cent of cases. Many go on to develop liver cancer.
The disease can be dormant for 15 to 20 years before symptoms appears.
Vancouver has some of the highest HIV rates per capita in North America
and Tyndall said the story's similar for hepatitis C.
But while needle exchange programs, safe-sex information and education
have helped reduce the climb of HIV rates, they aren't helping much for
hepatitis C.
"With hepatitis C, you practically have to eliminate the behaviors all together," said Dr. David Patrick, the lead researcher on the
study.
"It may not be a real-world goal at the moment. People's brains are
going to go for stimulation and some people will be prepared to stop and
others won't."
That means major implications for the health-care workers who will
eventually end up treating those with hepatitis C.
Patrick said the chances of picking up HIV after being pricked by a
needle are about three in 1,000. The chances of picking up hepatitis C
from a needle prick are 30 in 1,000.
A study published Monday on the New England Journal of Medicine Web site
found quick treatment after infection can almost always cure hepatitis
C.
Treatment with the medicine interferon within two or three months of
contracting the virus was found to be almost 100 per cent effective.
However, the approach may have limited practical effect because
early-stage infection is hard to spot and people don't immediately
realize they have caught the virus.
Tyndall said while harm reduction strategies have been shown to reduce
the HIV infection rate, there needs to be more focus on prevention of
injection drug use to curb the spread of hepatitis C.
But for current drug users in Vancouver, the battle's already lost.
"For hepatitis C, the cat's out of the bag. There's such a small
number of people that are still negative, it's going to be difficult to
change much. Most people are already infected."