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Survival of Hepatitis C Virus in Syringes Is Dependent on the Design of the Syringe-Needle and Dead Space Volume.

Binka M, Paintsil E, Patel A, Lindenbach BD, Heimer R - PLoS ONE (2015)

Bottom Line: One added a piston to the plunger; the other reduced the dead space within the needle.Most combinations with detachable needles required multiple rinses to reduce HCV infectivity to undetectable levels whereas a single rinse of insulin syringes was sufficient.Improved LDS designs may be able to further reduce HCV recovery, but based on the designed tested, LDS needles and syringes remain intermediate between fixed-needle syringes and HDS combinations in reducing exposure to HCV.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America.

ABSTRACT

Background: Many people who inject drugs (PWID) use syringes with detachable needles, which have high dead space (HDS). Contaminated HDS blood may substantially contribute to the transmission of HIV, hepatitis C (HCV), and other blood-borne viruses within this population. Newly designed low dead space (LDS) syringe-needle combinations seek to reduce blood-borne virus transmission among PWID. We evaluated the infectivity of HCV-contaminated residual volumes recovered from two LDS syringe-needle combinations.

Methods: We tested two different design approaches to reducing the dead space. One added a piston to the plunger; the other reduced the dead space within the needle. The two approaches cannot be combined. Recovery of genotype-2a reporter HCV from LDS syringe-needle combinations was compared to recovery from insulin syringes with fixed needles and standard HDS syringe-needle combinations. Recovery of HCV from syringes was determined immediately following their contamination with HCV-spiked plasma, after storage at 22°C for up to 1 week, or after rinsing with water.

Results: Insulin syringes with fixed needles had the lowest proportion of HCV-positive syringes before and after storage. HCV recovery after immediate use ranged from 47%±4% HCV-positive 1 mL insulin syringes with 27-gauge ½ inch needles to 98%±1% HCV-positive HDS 2 mL syringes with 23-gauge 1¼ inch detachable needles. LDS combinations yielded recoveries ranging from 65%±5% to 93%±3%. Recovery was lower in combinations containing LDS needles than LDS syringes. After 3 days of storage, as much as 6-fold differences in virus recovery was observed, with HCV recovery being lower in combinations containing LDS needles. Most combinations with detachable needles required multiple rinses to reduce HCV infectivity to undetectable levels whereas a single rinse of insulin syringes was sufficient.

Conclusions: Our study, the first to assess the infectivity of HCV in residual volumes of LDS syringes and needles available to PWID, demonstrates that LDS syringe-needle combination still has the greater potential for HCV transmission than insulin syringes with fixed needles. Improved LDS designs may be able to further reduce HCV recovery, but based on the designed tested, LDS needles and syringes remain intermediate between fixed-needle syringes and HDS combinations in reducing exposure to HCV.

No MeSH data available.


Related in: MedlinePlus

Residual viable HCV in LDS and HDS syringe-needle combinations after rinsing with water.Syringes were loaded with plasma spiked with HCV and rinsed once or twice with water and the frequency of HCV-positive syringes was determined. The percentage of HCV-positive syringes ±95% C.I. from at least 3 experiments are represented by each data point. G = Gauge. LDS = low dead space.
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pone.0139737.g006: Residual viable HCV in LDS and HDS syringe-needle combinations after rinsing with water.Syringes were loaded with plasma spiked with HCV and rinsed once or twice with water and the frequency of HCV-positive syringes was determined. The percentage of HCV-positive syringes ±95% C.I. from at least 3 experiments are represented by each data point. G = Gauge. LDS = low dead space.

Mentions: We determined HCV recovery after rinsing the syringe-needle combinations once or twice with water (Fig 6). In agreement with our previous report [24], one rinse with water reduced HCV infectivity to levels below the limit of detection in 1 mL insulin syringes with fixed 27G½” needles (Fig 6). The remaining syringe-needle combinations required multiple rinses to reduce residual infectivity to low levels (Fig 6). The 1 mL tuberculin syringes attached to PrecisionGlide™ 27G½” standard needles and the 2 mL Nevershare® syringes with Total Dose™ LDS 23G1¼” needles were the only two syringe-needle combinations with detachable needles that yielded no HCV-positive syringes after two rinses with water (Fig 6).


Survival of Hepatitis C Virus in Syringes Is Dependent on the Design of the Syringe-Needle and Dead Space Volume.

Binka M, Paintsil E, Patel A, Lindenbach BD, Heimer R - PLoS ONE (2015)

Residual viable HCV in LDS and HDS syringe-needle combinations after rinsing with water.Syringes were loaded with plasma spiked with HCV and rinsed once or twice with water and the frequency of HCV-positive syringes was determined. The percentage of HCV-positive syringes ±95% C.I. from at least 3 experiments are represented by each data point. G = Gauge. LDS = low dead space.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4633215&req=5

pone.0139737.g006: Residual viable HCV in LDS and HDS syringe-needle combinations after rinsing with water.Syringes were loaded with plasma spiked with HCV and rinsed once or twice with water and the frequency of HCV-positive syringes was determined. The percentage of HCV-positive syringes ±95% C.I. from at least 3 experiments are represented by each data point. G = Gauge. LDS = low dead space.
Mentions: We determined HCV recovery after rinsing the syringe-needle combinations once or twice with water (Fig 6). In agreement with our previous report [24], one rinse with water reduced HCV infectivity to levels below the limit of detection in 1 mL insulin syringes with fixed 27G½” needles (Fig 6). The remaining syringe-needle combinations required multiple rinses to reduce residual infectivity to low levels (Fig 6). The 1 mL tuberculin syringes attached to PrecisionGlide™ 27G½” standard needles and the 2 mL Nevershare® syringes with Total Dose™ LDS 23G1¼” needles were the only two syringe-needle combinations with detachable needles that yielded no HCV-positive syringes after two rinses with water (Fig 6).

Bottom Line: One added a piston to the plunger; the other reduced the dead space within the needle.Most combinations with detachable needles required multiple rinses to reduce HCV infectivity to undetectable levels whereas a single rinse of insulin syringes was sufficient.Improved LDS designs may be able to further reduce HCV recovery, but based on the designed tested, LDS needles and syringes remain intermediate between fixed-needle syringes and HDS combinations in reducing exposure to HCV.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America.

ABSTRACT

Background: Many people who inject drugs (PWID) use syringes with detachable needles, which have high dead space (HDS). Contaminated HDS blood may substantially contribute to the transmission of HIV, hepatitis C (HCV), and other blood-borne viruses within this population. Newly designed low dead space (LDS) syringe-needle combinations seek to reduce blood-borne virus transmission among PWID. We evaluated the infectivity of HCV-contaminated residual volumes recovered from two LDS syringe-needle combinations.

Methods: We tested two different design approaches to reducing the dead space. One added a piston to the plunger; the other reduced the dead space within the needle. The two approaches cannot be combined. Recovery of genotype-2a reporter HCV from LDS syringe-needle combinations was compared to recovery from insulin syringes with fixed needles and standard HDS syringe-needle combinations. Recovery of HCV from syringes was determined immediately following their contamination with HCV-spiked plasma, after storage at 22°C for up to 1 week, or after rinsing with water.

Results: Insulin syringes with fixed needles had the lowest proportion of HCV-positive syringes before and after storage. HCV recovery after immediate use ranged from 47%±4% HCV-positive 1 mL insulin syringes with 27-gauge ½ inch needles to 98%±1% HCV-positive HDS 2 mL syringes with 23-gauge 1¼ inch detachable needles. LDS combinations yielded recoveries ranging from 65%±5% to 93%±3%. Recovery was lower in combinations containing LDS needles than LDS syringes. After 3 days of storage, as much as 6-fold differences in virus recovery was observed, with HCV recovery being lower in combinations containing LDS needles. Most combinations with detachable needles required multiple rinses to reduce HCV infectivity to undetectable levels whereas a single rinse of insulin syringes was sufficient.

Conclusions: Our study, the first to assess the infectivity of HCV in residual volumes of LDS syringes and needles available to PWID, demonstrates that LDS syringe-needle combination still has the greater potential for HCV transmission than insulin syringes with fixed needles. Improved LDS designs may be able to further reduce HCV recovery, but based on the designed tested, LDS needles and syringes remain intermediate between fixed-needle syringes and HDS combinations in reducing exposure to HCV.

No MeSH data available.


Related in: MedlinePlus