Dünya Sağlık Örgütü (DSÖ) uyuşturucu kullananlarda Hepatit B ve C’nin Önlenmesi konulu Kılavuz yayımladı… (ing)



WHO Issues Guidance on Prevention of HBV, HCV Infection

July 25, 2012 — The World Health Organization (WHO) has issued new guidelines for countries to prevent the spread of viral hepatitis B (HBV) and C (HCV) among people who inject drugs. In its “Guidance on Prevention of Hepatitis B and C Among People Who Inject Drugs,” the WHO recommends 4 actions for countries to take:

  1. offer people who inject drugs the rapid HBV vaccination regimen, which takes 3 weeks to administer the 3 doses, instead of 6 months;
  2. offer people who inject drugs incentives to increase uptake and completion of the HBV vaccination schedule;
  3. implement needle and syringe programs to provide low-dead-space syringes that retain less blood after use; and
  4. offer peer interventions to people who inject drugs in an effort to reduce incidence of viral hepatitis.

The WHO recommends that the guidance “should be implemented in phases, consistent with the level of resources available.” The guidance also stipulates that psychosocial or behavioral interventions are not suggested for people who inject drugs because, per systematic review, no evidence indicates that such measures are effective at reducing hepatitis rates.

Parallels HIV Prevention Measures for Injectable Drug Users

The recommendations resemble measures that have been implemented for prevention of HIV/AIDS. “Most of the interventions that prevent HIV transmission between people who inject drugs are virtually the same as those for preventing viral hepatitis B and C,” Gottfried Hirnschall, MD, director of the WHO Department for HIV/AIDS, said in a WHO news release. “So it makes sense to reduce the risk of both infections by linking viral hepatitis prevention with HIV prevention, care and treatment.”

An estimated 240 million people are infected with HBV and 170 with HCV, far exceeding the 34 million infected with HIV, according to the WHO. In 2011, the organization estimates, 1.2 million people who inject drugs were infected with HBV, and 10 million were infected with HCV.

Estimated prevalence of hepatitis infection is higher than 50% among people who inject drugs in most countries and higher than 80% in 12 countries. The largest populations of infected people who inject drugs are in the Russian Federation (73% estimated prevalence), the United States (72%), and China (67%), according to the WHO. An estimated 16 million people in 148 countries inject drugs, the WHO report also states.

Sharing contaminated syringes is the most common method of infection transmission. Despite the recommendation that countries implement needle and syringe programs as a crucial public health measure, many countries have not done so, and the global response to hepatitis spread has been poor, according to the WHO.

The HBV vaccine is inexpensive, safe, and effective, yet vaccination rates for HBV among people who inject drugs are lower than for the general population, the organization says. Because no vaccine exists for HCV, an urgent need exists to identify other measures to prevent hepatitis spread.

“Countries that have adopted a public health approach to injecting drug use and HIV have been the most successful in turning round their HIV epidemics. We need to do the same for hepatitis,” Ying-Ru Lo, MD, from the WHO’s HIV Department, said in the news release.

Guidance on Prevention of Hepatitis B and C Among People Who Inject Drugs.” WHO.