Reduced risk of hepatitis B and hepatitis C among injection drug users in the Tacoma syringe exchange program

• Published in: American journal of public health (1971) Vol. 85; no. 11; pp. 1531 - 1537
• Main Authors: Hagan, H, Jarlais, D C, Friedman, S R, Purchase, D, Alter, M J
• Format: Journal Article
• Language: English
• Published: Washington, DC Am Public Health Assoc 01-11-1995; American Public Health Association
• Subjects: Acute Disease; Adult; Age Factors; Antibodies; Antigens; Biological and medical sciences; Case-Control Studies; Confidence intervals; Confounding (Statistics); Data collection; Disease transmission; Drugs; Enzymes; Female; Hepatitis; Hepatitis A; Hepatitis B; Hepatitis B - etiology; Hepatitis B - prevention & control; Hepatitis C; Hepatitis C - etiology; Hepatitis C - prevention & control; HIV; Human immunodeficiency virus; Human viral diseases; Humans; Infections; Infectious diseases; Intravenous drug addicts; Male; Medical laboratories; Medical research; Medical sciences; Medical tests; Methadone; Needle exchange programs; Needle exchange schemes; Needle-Exchange Programs - statistics & numerical data; Pharmacy; Public health; Risk Factors; Risk reduction; Sex Factors; Substance Abuse, Intravenous - complications; Surveillance; Tacoma; Tuberculosis; Viral diseases; Viral hepatitis; Viruses; Washington; United States; North America; America; United States > US; Tacoma Washington; Human; Sanitary program; Drug addiction; Intravenous administration; Hepatic disease; Epidemiology; Infection; Exchange; Viral hepatitis B; Prevention; Viral disease; Syringe; Digestive diseases; Public health; Viral hepatitis C
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.85.11.1531

This case-control study examined the association between syringe exchange use and hepatitis B and C in injection drug users.
Case patients included 28 injection drug users with acute hepatitis B and 20 with acute hepatitis C reported to the health department in a sentinel hepatitis surveillance county; control subjects were injection drug users with no markers of exposure to hepatitis B or C (n = 38 and 26, respectively) attending health department services during the same period. Data were abstracted from clinic records.
Seventy-five percent of case patients with hepatitis B and 26% of control subjects had never used the exchange; similar proportions were found for the hepatitis C case and control groups. After adjustment for demographic characteristics and duration of injecting drugs, nonuse of the exchange was associated with a sixfold greater risk of hepatitis B (odds ratio [OR] = 5.5; 95% confidence interval [CI] = 1.5, 20.4) and a sevenfold greater risk of hepatitis C (OR = 7.3; 95% CI = 1.6, 32.8).
The results suggest that use of the exchange led to a significant reduction in hepatitis B and hepatitis C in the county and may have also prevented a substantial proportion of human immunodeficiency virus infections in injection drug users.