Objective: To determine whether disinfection of needles with bleach has a potentially protective effect on HCV seroconversion. Methods: We conducted a nested case-control study comparing 78 HCV seroconverters with 390 persistently HCV seronegative IDUs. These data come from the Collaborative Injection Drug Users Studies-II that recruited IDUs aged 18-30 from five U.S. cities for HCV testing and interviews at baseline, 6, and 12 month follow-up visits. Up to 5 controls were matched to each case on gender, race/ethnicity, recent (last 6 months) injection, date of study entry, and length of follow-up. Conditional logistic regression was used to determine the effect of bleach disinfection on HCV seroconversion. Results: Participants who reported using bleach all the time had an odds ratio (OR) for HCV seroconversion of .35 (95% CI .08 - 1.62) whereas those reporting bleach use less then all the time had an OR of .76 (95% CI .21 - 2.70) when compared to those reporting no bleach use. The apparent association of bleach and HCV seroconversion was maintained or was virtually unchanged in the presence of putative risk factors (including frequency of injection and sharing of syringes, cottons, cookers and rinse water). Conclusions: In the absence of a statistical association, the point estimate suggests that further studies to evaluate a protective effect of bleach disinfection for preventing HCV infection are warranted. While not a substitute for use of sterile needles or cessation of injection, bleach disinfection should be studied for its potential to protect against HCV seroconversion.
Learning Objectives: N/A
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.