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V. Anna Gyarmathy, Receptive Syringe Sharing and Infection Risk: To Clean or Not To Clean, The Journal of Infectious Diseases, Volume 202, Issue 3, 1 August 2010, Page 499, https://doi.org/10.1086/653840
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To the Editor—It was with great interest that I read the recent article by Hagan et al [1], who assessed predictors of hepatitis C virus (HCV) seroconversion among a cohort of 483 injection drug users in 5 US cities. The authors performed a set of 8 multivariate analyses elaborating on the association of incident HCV infection with different combinations of injecting equipment sharing, and they found that the shared use of drug preparation equipment was significantly associated with HCV seroconversion, whereas receptive syringe sharing was not. In their discussion, the authors explain the lack of association of receptive syringe sharing with HCV seroconversion with the deliberate risk reduction strategy of participants to share syringes only with low-risk partners.
In a cross-sectional study among injecting drug users in Hungary, we explored associations with prevalent HCV infections [2]. To examine the role played by syringe cleaning in prevalent HCV infection, we created 2 variables for receptive syringe sharing: receptive syringe sharing that always included cleaning before sharing, and receptive syringe sharing that did not always include cleaning before sharing. We found that, although receptive sharing of (1-piece) syringes when the syringes were always cleaned before sharing was not associated with prevalent HCV infection (multivariate adjusted odds ratio [AOR], 0.7 [95% confidence interval {CI}, 0.2–1.9]), receptive syringe sharing when the syringe was not always cleaned showed a strong association (multivariate AOR, 3.1 [95% CI, 1.1–8.9]). We concluded that, in our study population, thorough cleaning of used 1-piece syringes before receptive sharing diminished the risk of HCV infection to the level of using sterile syringes [2].
