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. 2018 Jan 15;15(1):3.
doi: 10.1186/s12954-017-0207-5.

Options for reducing HIV transmission related to the dead space in needles and syringes

William A Zule  1 , Poonam G Pande  2 , David Otiashvili  3 , Georgiy V Bobashev  4 , Samuel R Friedman  5 , V Anna Gyarmathy  6 , Don C Des Jarlais  7
Affiliations

Options for reducing HIV transmission related to the dead space in needles and syringes

William A Zule et al. Harm Reduct J. .

Abstract

Background: When shared by people who inject drugs, needles and syringes with different dead space may affect the probability of HIV and hepatitis C virus (HCV) transmission differently.

Methods: We measured dead space in 56 needle and syringe combinations obtained from needle and syringe programs across 17 countries in Europe and Asia. We also calculated the amounts of blood and HIV that would remain in different combinations following injection and rinsing.

Results: Syringe barrel capacities ranged from 0.5 to 20 mL. Needles ranged in length from 8 to 38 mm. The average dead space was 3 μL in low dead space syringes with permanently attached needles, 13 μL in high dead space syringes with low dead space needles, 45 μL in low dead space syringes with high dead space needles, and 99 μL in high dead space syringes with high dead space needles. Among low dead space designs, calculated volumes of blood and HIV viral burden were lowest for low dead space syringes with permanently attached needles and highest for low dead space syringes with high dead space needles.

Conclusion: The dead space in different low dead space needle and syringe combinations varied substantially. To reduce HIV transmission related to syringe sharing, needle and syringe programs need to combine this knowledge with the needs of their clients.

Keywords: Dead space; HIV; Hepatitis C virus; Needle and syringe programs; Needles; People who inject drugs; Syringes.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable

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Not applicable

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Needle and syringe designs that affect dead space. a Standard (high dead space) syringe with standard needle. Average dead space (99 μL). b Low dead space syringe with permanently attached needle. Average dead space (3 μL). c Standard syringe with low dead space needle. No needle and syringe programs sent us low dead space needles (c) or a low dead space syringe (d) with a standard needle. However, use of both of these has become more common. We obtained samples of c and d from the manufacturers: c Covidien and d Henke-Sass
Fig. 2
Fig. 2
a City, country, and types of syringes sent. b Examples of needles and syringes from different cities
Fig. 3
Fig. 3
a Distribution of needle lengths and gauges. The size of the dots indicates the number of different needles of a specific length and gauge that we received. The smallest dots represent 1 needle and the largest dot represents 22 needles. b Dead space in needle and syringe combinations, by design
Fig. 4
Fig. 4
a Volume of blood by barrel capacity and low dead space permanently attached needle or high dead space detachable needle after injection, booting, first rinse, and second rinse. b Volume of blood by low dead space design after injection, booting, first rinse, and second rinse. c HIV viral burden after injection, booting, first rinse, and second rinse. The asterisk indicates low dead space syringe with permanently attached needle
See this image and copyright information in PMC

References

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