(Recommendation of British Advisory Council on Misuse of Drugs) "Recommendation 1. Local service planners need to review local needle and syringe services (and be supported in this work) in order to take steps to increase access and availability to sterile injecting equipment and to increase the proportion of injectors who receive 100 per cent coverage of sterile injecting equipment in relation to their injecting frequency."
(Hepatitis C Virus and Injection Drug Use) "HCV infection in IDUs [intravenous drug users] is acquired primarily through injecting with an infected needle and syringe, which has been used by someone else who is infected with HCV or possibly has become contaminated through contact with other contaminated injecting paraphernalia. The probability of becoming infected after using an infected syringe ranges from 1.5 to 5 per cent for HCV, in contrast to 0.34 to 1.4 per cent for HIV (Vickerman et al., in press)."
(Number of HCV Infections and Deaths Worldwide) "About 150 million people are chronically infected with HCV. More than 350,000 people are estimated to die from HCV-related liver diseases each year. Exposure to blood through injections with non-sterile equipment or transfusion of infected blood products is a common and preventable cause of HBV and HCV infections."
(Incidence Rate and Number of Cases of Acute Hepatitis C Infections in the US) "In 2014, a total of 2,194 cases of acute hepatitis C were reported to CDC from 40 states (Table 4.1). The overall incidence rate for 2014 was 0.7 cases per 100,000 population, an increase from 2010–2012. After adjusting for under-ascertainment and under-reporting, an estimated 30,500 acute hepatitis C cases occurred in 2014.
(Injection Drug Use and Transmission of Hepatitis C) "The potential for blood-borne viral transmission via injection equipment other than syringes was reported in an earlier study of equipment collected in a Miami shooting gallery, where HIV-1 DNA was detected in rinses from cottons and cookers and in water used to clean paraphernalia and to dissolve drugs. A sterile syringe may become contaminated when the tip of the needle is inserted into a contaminated cooker or when the drug is drawn up through contaminated filtration cotton.
(Hepatitis C Virus and Injection Drug Use) "Hepatitis C virus (HCV) infection is very common among injection drug users. Studies of injection drug users in regions with a longstanding pattern of endemic injection drug use have reported prevalences of HCV antibody in the range of 65% to 90%, even where HIV prevalence is quite low.1-5 The majority of HCV infections become chronic, resulting in a large reservoir of HCV infection among injection drug users.
(HCV Mortality and Costs, 1998) "In the United States, chronic HCV infection accounts for 8,000 to 10,000 related deaths annually.1,3 It has become the leading cause of liver transplantation, accounting for 30% of all liver transplants. The Centers for Disease Control and Prevention (CDC) conservatively estimates expenditures devoted to HCV to be more than $600 million annually."
(Hepatitis C Infections in the US in 2007, by Transmission Methods) "Of the cases reported in 2007 for which information concerning exposures during the incubation period was available, the most common risk factor identified was IDU (48%). During 1998–2007, IDU [intravenous drug use] was reported for an average of 44% of persons (range: 38%–54%). In 2007, 42% reported having multiple sex partners during the incubation period, 10% reported having sexual contact with another known HCV-infected person, and 10% were MSM [men who have sex with men].
(Progression from Acute to Chronic HCV Infection) "No laboratory distinction can be made between acute and chronic (past or present) HCV infection. Diagnosis of chronic infection is made on the basis of anti-HCV positive results upon repeat testing. Approximately 75%-85% of newly infected persons develop chronic infection (14).
Hepatitis C Prevention:
"• Infection control precautions in health care and community settings can prevent transmission of viral hepatitis as well as many other diseases.
"• Safe injection practices can protect against HBV and HCV transmission.
"• Safer sex practices, including minimizing the number of partners and using barrier protective measures (condoms), protect against HBV and possibly against HCV transmission.
"• Harm reduction practices for injecting drug users prevent HAV, HBV and HCV transmission."