UC San Francisco researchers are recommending a combination of six comprehensive measures to prevent the spread of hepatitis C, in an effort to address the more than 31,000 young people they estimate may be newly infected with the virus each year in the United States due to injection-drug use.
The measures, which stem from a 16-year UCSF research project with injection-drug users, known as the U Find Out or UFO Study, build upon the successes of clean syringe programs and similar efforts, while recommending greater focus on the social issues behind drug use and further integration of the multiple approaches to combating hepatitis C.
In February, the U.S. Department of Health and Human Services (HHS) noted the rising epidemic of hepatitis C virus among young people aged 15-30 who inject drugs, calling attention to an increasingly serious issue nationwide. While data on hepatitis C are limited, the HHS estimates that as many as 3.9 million people in the United States are living with a chronic form of the disease, which the researchers said is at least 10 times more infectious than HIV. In 2007, the number of U.S. deaths associated with hepatitis C surpassed those from HIV for the first time.
Based on our UFO Study here in San Francisco, we have accumulated data that identify key strategies that, when scaled up, could substantially reduce the rate of new hepatitis C infections among young people who inject drugs, says the studys lead investigator, Kimberly Page, PhD, MPH, a professor in the UCSF Department of Epidemiology and Biostatistics, and in UCSF Global Health Sciences.
The research team examined several data sources to arrive at the new estimate of 31,000 new cases per year and identified six areas where prevention efforts should be focused. Findings appear online July 24, 2013, in a special supplement titled, Prevention and Management of Hepatitis C Virus among People Who Inject Drugs: Moving the Agenda Forward, in the journal Clinical Infectious Diseases. The publication coincides withWorld Hepatitis Week, July 21-28, 2013.
First, while syringe-exchange programs have long been recognized as an absolutely essential element in disease prevention, giving injectors access to clean needles and syringes, the UFO Studyteam discovered that up to 40 percent of infections occurred from exposures to shared drug preparation containers, filters, and rinse water.
The hepatitis C virus lives a long time on surfaces and can easily contaminate various types of injecting equipment, so while expanding needle exchanges throughout the country is essential, one of our critical recommendations is that existing and newly established exchanges provide clean ancillary equipment along with needles and syringes, says Page.
Additional strategies identified in the paper include hepatitis C virus screening, testing and counseling; targeting interventions to address the social and relational contexts of injecting; injection cessation interventions to reduce risks of exposure; development of models to guide roll out of new hepatitis C treatments and vaccines; and the implementation of robust, scaled interventions in combination to synergize the effectiveness of individual interventions.
A new rapid test for hepatitis C has become available that can be delivered at the point of care with results in 20 minutes, so making that widely available can significantly improve screening, testing and counseling, says Page. Also, our research identified the value of taking breaks for both reducing the risks of exposure to the virus and helping end injection drug use.
The UFO Study looked at the behaviors associated with attempts by injectors to complete various injection cessation programs, such as 12 step or opiate substitution programs. While in these programs, exposure risks disappeared. However, while injectors frequently fail cessation programs, the UFO Study showed that the more injectors try to quit, or take breaks from drugs, the more likely they eventually are to succeed. That new data could inform how these and other treatment programs handle relapses in the future.
Often these programs are very unforgiving and relapses can lead to permanent bans, Page says. This is likely not the best tactic for reducing disease exposure risks and also may not be optimal for helping injectors end injection drug use.
Co-authors include Meghan Morris and Judith A. Hahn from UCSF; Lisa Maher from the Kirby Institute in Sydney, Australia; and Maria Prins from the Public Health Service in Amsterdam, The Netherlands.
The UFO Study, which began in September 1997, is a constellation of research studies and projects focusing primarily on viral hepatitis, particularly hepatitis C virus, among young injection drug users in San Francisco. The research was funded by the U.S. National Institute on Drug Abuse and the Australian Government Department of Health and Ageing.
Source: University of California, San Francisco (UCSF)
The Next Frontier in Infection Control: AI-Driven Operating Rooms
Published: July 15th 2025 | Updated: July 15th 2025Discover how AI-powered sensors, smart surveillance, and advanced analytics are revolutionizing infection prevention in the OR. Herman DeBoard, PhD, discusses how these technologies safeguard sterile fields, reduce SSIs, and help hospitals balance operational efficiency with patient safety.
Targeting Uncertainty: Why Pregnancy May Be the Best Time to Build Vaccine Confidence
July 15th 2025New national survey data reveal high uncertainty among pregnant individuals—especially first-time parents—about vaccinating their future children, underscoring the value of proactive engagement to strengthen infection prevention.
CDC Urges Vigilance: New Recommendations for Monitoring and Testing H5N1 Exposures
July 11th 2025With avian influenza A(H5N1) infections surfacing in both animals and humans, the CDC has issued updated guidance calling for aggressive monitoring and targeted testing to contain the virus and protect public health.
IP LifeLine: Layoffs and the Evolving Job Market Landscape for Infection Preventionists
July 11th 2025Infection preventionists, once hailed as indispensable during the pandemic, now face a sobering reality: budget pressures, hiring freezes, and layoffs are reshaping the field, leaving many IPs worried about their future and questioning their value within health care organizations.