Author: Sharkey C, Kelly D, Stephens BP, Qumsieh J, Nelson Y, Knight D, Ahmad F, Holt F, Hutton C, Johnstone C, Dillon JF

Theme: Models of Care Year: 2019

Background: An influx in inexperienced users of image and performance enhancing drugs (IPED),
attending an injecting equipment provision (IEP) service demonstrated gaps in awareness over
screening for Hepatitis-C.
Concurrently, users of oral IPEDs in conjunction with alcohol or recreational substance misuse
evidenced potentiality for incurring metabolic syndrome and liver damage.
Description of model of care/intervention: Attendees are offered Fib4, liver panel, full blood count,
cholesterol, triglycerides, lipids and blood borne virus (BBV) screening by venous blood.
Liver fibrosis is assessed by Fibroscan®.
Effectiveness: All sixty-eight attendees surveyed were males injecting IPED’s, whilst 22% augmented
oral-cycles of anabolic androgenic steroids (AAS).
All agreed to have a Fibroscan®.
39% provided bloods to calculate Fib4 scores, of which 94% evidenced no greater than mild fibrosis.
Raised cholesterol and triglycerides were noted with 40% of those screened.
29% disclosed regularly consuming cocaine with alcohol, with 4% reporting 3,4-Methylenedioxy
methamphetamine (MDMA) and cannabis use.
50% of attendees agreed to BBV screening with 100% so far returning negative.
Internet forums and peer awareness were familiar sources interpreting IPED validity with popularity
and reputed sales regarded references of approval before users knowingly procured products via
unregistered websites.
Flawed experiential technique of intramuscular administration brought frequency of bacterial
infections and tissue scarring.
Conclusion and next steps: The fact Hepatitis C wasn’t detected within this sample group is a
welcomed outcome.
Opting to monitor bloods via independent laboratories without regulation or expert interpretation
of results may misrepresent IPED user’s wellbeing and inadvertently impede informed decision
Assurances were served, oral IPEDs may elevate cholesterol and triglycerides, therefore diet alone
could not solely be accountable to presence of markers indicative to onset of NAFLD.
Whilst there is growing impetus for Hepatitis C screening, this survey suggests there remains
imparity in efforts to openly monitor IPED populations risk of acquiring Liver damage.
Disclosure of Interest Statement: CS, DK2
, JQ, YN, DK1
, FA, FH, CH, CJ, declare no conflict of interest.
BPS has honoraria for lectures from Janssen-Cilag, Merck Sharp & Dohme and Gilead Sciences.
JFD has honoraria for lectures and research grants from Janssen-Cilag, Roche, Merck Sharp &
Dohme, AbbVie, Bristol-Myers Squibb, & Gilead.

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