[Effect of needle and syringe exchange programs on the spread of viral hepatitis C]

The authors examined a total of 224 clients (147 men and 77 women) of the Contact centre for drug-dependent subjects "Drug out" in Ustí nad Labem. The subjects, parenteral abusers of hard drugs. The majority of examined subjects were 20-24 years old and accounted for 50.9% of the whole group. In all the history of abuse was assessed, the type of drug they took and are taking at present, how long they have been taking it, route of administration of the drug. Participation in the exchange programme was focused on the adherence to using their own injection tools. In addition the authors assessed whether the subjects had hepatitis. After they obtained informed consent, if possible, 4 ml venous blood samples were taken. The blood was examined for anti-HCV by the method of micro-enzyme immunoassay (MEIA) on an Axsym apparatus of Abbott Co. The positive response to anti-HCV was assessed in 83, i.e. 37.1%. Abusers who took drugs for longer periods were more frequently infected. So far it proved possible to obtain samples repeatedly from 38 clients who were originally negative. In the latter new positivity was found in 36.8%. The incidence of new positivity is 35.7/100/year. Evaluation of the participation in the exchange programme of needles and syringes was made with the following conclusion the provisions resolve the position only partly, they reduce the rate of spread of infections but do not eliminate the risk. The spread of VHC in the population of drug abusers is due to the risky procedure during preparation of the drug dose and lack of adherence to the principle of using their own needles and syringes. During implementation of preventive programmes in the population a comprehensive approach is needed including information on the spread of viral hepatitis and HIV infection. VHC is a problem to which systematic attention must be paid on account of its impact on health and economics. These problems cumulate and develop after a certain time interval.