Combined opioid substitution treatment (OST) and needle and syringe programmes (NSP) to prevent HCV (and HIV) infection and reduce injecting risk behaviours

Summary of the evidence

Rating
  • Beneficial

Combined OST and high NSP coverage has been found to be effective in a systematic review with meta-analysis (Platt et al., 2017, 28 studies, N= 11 070 PWID) in:

  • reducing the risk of HCV acquisition by 74 % (RR 0.26 95% CI 0.07 to 0.89).

Another systematic review (Palmateer et al., 2022, 27 systematic review, 61 studies) confirmed the results and found sufficient evidence to support the combination of OST and NSP in:

  • the prevention of HCV transmission among PWID.
  • the prevention of injecting risk behaviour among PWID.

While there are still not enough studies to assess the effect on HIV, considering the positive effect on HCV, experts assume the same positive effect on HIV infections.

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