Back HCV Prevention Water and Filters Used for Drug Injection May Transmit Hepatitis C Virus

Water and Filters Used for Drug Injection May Transmit Hepatitis C Virus

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Water, containers, and material used to mix and filter heroin -- not just syringes -- can harbor hepatitis C virus (HCV) and contribute to transmission among injection drug users, according to a study published in the November 5, 2012, advance edition of the Journal of Infectious Diseases.

HCV is a blood-borne virus that is highly prevalent among injection drug users, especially in areas without needle exchanges or other harm reduction interventions.Research by Elijah Paintsil and colleagues has shown that HCV can live for weeks in syringes under favorable conditions. But the virus may also be transmitted via other injection equipment.

Juliane Doerrbeckerfrom the Medical School of Hannover and Helmholtz Centre for Infection Research and colleagues in Germany looked at the risk of HCV transmission associated with water used to dilute drugs, water containers, and filters (such as cotton).

Experiments were designed to replicate the practices of people who inject drugs, with routinely used injection equipment.

Viral stability in water was assessed by adding HCV to 100 mL of bottled water and letting it stand for several days at room temperature. Stability in containers was determined by filling aluminum, glass, and plastic containers with water, adding HCV, emptying the water, and refilling the container with new water. Transmission associated with filters was determined by drawing virus through a filter, wrapping it in foil, and incubating it to release viral particles.

Results

  • HCV was able to survive for 3 weeks in bottled water, although its infectivity decreased over time.
  • Infectious virus particles could be detected in water containers even after rinsing.
  • Physical properties of containers determined the extent of HCV contamination, with virus remaining longer in those made of aluminum or plastic.
  • HCV was also associated with filter material, with about 10% of the original amount of virus remaining detectable after 24 to 48 hours.

"This study demonstrates the potential risk of HCV transmission among injection drug users who share water, filters, and water containers," the study authors concluded. "These findings add strong evidence to the high transmission rate of HCV when sharing these drug preparation materials and should help in the design of prevention strategies aimed at reducing HCV transmission."

"The findings described here should help to raise awareness and emphasize the risk of sharing drug preparation materials," they recommended in their discussion. "Prevention messages and campaigns should be revised to notify people who inject drugs to the importance of eliminating all equipment-sharing practices" and harm reduction programs should supply other injection equipment along with syringes.

1/11/13

Reference

J Doerrbecker, P Behrendt, P Mateu-Gelabert, et al. Transmission of Hepatitis C Virus Among People Who Inject Drugs: Viral Stability and Association With Drug Preparation Equipment. Journal of Infectious Diseases 207(2):281-287. January 15, 2013.