Drug injectors at risk of Hepatitis C

A study, done in 2015 in Nairobi and Mombasa, has found that one in every three drug injectors, known as People Who Inject Drugs (PWID), is living with Hepatitis C.

The yet to be released study, is a collaborative work of Kenya Medical Research Institute (Kemri) and Kenya Aids NGOs Consortium (Kanco), sampled 552 PWIDs: 152 from Nairobi and 400 from Mombasa.

“The objective was to carry out an evaluation on prevalence of Hepatitis C and Hepatitis B among people who inject drugs in the two cities,” says Sylvia Ayon, Programme Manager, Community Action on Harm Reduction.

According to the findings, 36 per cent of PWID had the Hepatitis C virus (HCV), 22 per cent had both HCV and HIV infections, only five per cent of this group had just HIV while 37 per cent were free from any infection.

This study has manifested similar results to a different study – published in the Lancet Infectious Disease journal in May last year. The study, which was conducted in 33 countries, found that among sub-Saharan Africa, Kenya has the highest HCV–HIV co-infection rate.

The research, conducted by a team from Imperial College London and Medecins Sans Frontieres, found that the rate in Kenya stands at nine and 12 per cent.

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Surprisingly, countries with a higher HIV prevalence — South Africa, Botswana, Zimbabwe, Zambia, Mozambique, and Malawi — were all found to have low-to-moderate levels of HCV co-infection. Except Mozambique, all the others had less than five per cent co-infection rate.

Part of the team’s findings was an indication that prevalence of HCV infection in HIV-infected individuals was substantially higher than that in blood donor or antenatal clinic groups: a trend believed to mimic trends in the general population.

Hepatitis is a disease of the liver in which viruses cause the liver to enlarge and stop functioning properly.

According to Dr Peter Borus of Kemri, Hepatitis C is spread mainly by contact with an infected person’s blood, which includes sharing injection equipment.

“Drug injectors are considered high risk groups compared to others in the population who don’t inject drugs. It should also be known that PWID are also prone to other high risk behaviors such as prostitution,” Dr Borus said.

The study by the Kemri/Kanco team also looked into Hepatitis B prevalence which they found to be lower among PWID and much closer to that found in the general population at 3.9 per cent.

According to Kanco, it is unfortunate that the government currently has no treatment plan for Hepatitis B and C.

“Most patients have to purchase their own drugs. Unlike HIV, where there is a strong donor and government support programme, treatment is only available at referral public hospitals, high end private hospitals and specialist clinics,” Sylvia says.

This, together with the high cost of treatment — one needs between Sh70,000 and Sh120,000 — makes it difficult for PWID to receive timely medical attention in fighting the disease.

There are few laboratories that offer Hepatitis B and Hepatitis C Viral load testing. So far, only Kemri, the Aga Khan University Hospital and Nairobi hospital offer the service at a cost of about Sh15,000.

There is no vaccine for HCV, unlike Hepatitis A and B, and medics primarily rely on preventive measures to control the disease.