January 11, 2013

Transmission of Hepatitis C Virus Among People Who Inject Drugs: Viral Stability and Association With Drug Preparation Equipment

J Infect Dis. (2012) doi: 10.1093/infdis/jis677

First published online: November 5, 2012

Juliane Doerrbecker1, Patrick Behrendt1,2, Pedro Mateu-Gelabert4, Sandra Ciesek1,2, Nina Riebesehl1, Corinne Wilhelm1, Joerg Steinmann3, Thomas Pietschmann1 and Eike Steinmann1

+ Author Affiliations

Correspondence: Eike Steinmann, PhD, Division of Experimental Virology, Twincore Center for Experimental and Clinical Infection Research, Feodor-Lynen-Stra├če 7-9, 30625 Hannover, Germany (eike.steinmann@twincore.de).


Background. Hepatitis C virus (HCV) transmission among people who inject drugs remains a challenging public health problem. We investigated the risk of HCV transmission by analyzing the direct association of HCV with filters, water to dilute drugs, and water containers.

Methods. Experiments were designed to replicate practices by people who inject drugs and include routinely used injection equipment. HCV stability in water was assessed by inoculation of bottled water with HCV. Viral association with containers was investigated by filling the containers with water, inoculating the water with HCV, emptying the water, and refilling the container with fresh water. Transmission risk associated with drug preparation filters was determined after drawing virus through a filter and incubating the filter to release infectious particles.

Results. HCV can survive for up to 3 weeks in bottled water. Water containers present a risk for HCV transmission, as infectious virions remained associated with water containers after washing. Physical properties of the water containers determined the degree of HCV contamination after containers were refilled with water. HCV was also associated with filter material, in which around 10% of the viral inoculum was detectable.

Conclusions. This study demonstrates the potential risk of HCV transmission among injection drug users who share water, filters, and water containers and will help to define public health interventions to reduce HCV transmission.

Received July 9, 2012. Accepted August 21, 2012.


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