Harm Reduction Centres

A pilot project, involving three harm reduction centres and needle exchange facilities, linked to the hepatitis C network based in Nice (Réseau Hépatite C Ville-Hôpital Côte d’Azur) has sought to increase the diagnosis and treatment of People Who Inject Drugs (PWID).


Harm reduction centres and needle exchange facilities serve the health needs of PWID. The number of PWID who are successfully diagnosed with hepatitis C and linked to the appropriate care remains low. Frequently, the problem relates to the time it takes to diagnose people living in vulnerable conditions. Hepatitis C treatment is based on the detection of a positive viral load in the blood using a RT-PCR test. The process can be accelerated through rapid RT-PCR tests using capillary blood, taken from the fingertip. These tests provide results in less than an hour. This makes it more likely that PWID who test positive will remain within reach to receive their results. They can then be offered advice and the appropriate care required to cure their hepatitis C.


A total of 183 PWID took part in the project with the majority being men (79%). The average age was 44, and more than 50% lived in vulnerable conditions (22 had no social security, 40 lived in precarious housing and 42 were homeless). A hepatitis C antibody test was carried out in 180 of the 183 PWID, returning positive in 85 (47%) of the cases. [HBV surface antigen (HBsAG) was positive in 9 and HIV in 4 of the PWID]. 82 out of the 85 serology-positive PWID agreed to a rapid RT-PCR with the test coming up positive in 29 i.e. a prevalence of 16% of all PWID. Following counselling, 18 PWID agreed to initiate treatment.

Close-up of doctor take blood of client finger with glass tube, usual procedure at clinic. Planned test for client on appointment. Medicine, clinic concept


Measuring the HCV viral load through rapid RNA testing in sites which are specifically equipped to serve the health needs of PWID can improve the diagnosis and linkage to care of this risk group.


Private funding.


Denis Ouzan, Réseau ville hôpital hépatite C Côte d’Azur