Hepatitis C virus among non-injecting cocaine users (NICUs) in South America: can injectors be a bridge?
Article first published online: 19 OCT 2010
© 2010 The Authors, Addiction © 2010 Society for the Study of Addiction
Volume 106, Issue 1, pages 143–151, January 2011
How to Cite
Caiaffa, W. T., Zocratto, K. F., Osimani, M. L., Martínez, P. L., Radulich, G., Latorre, L., Muzzio, E., Segura, M., Chiparelli, H., Russi, J., Rey, J., Vazquez, E., Cuchi, P., Sosa-Estani, S., Rossi, D. and Weissenbacher, M. (2011), Hepatitis C virus among non-injecting cocaine users (NICUs) in South America: can injectors be a bridge?. Addiction, 106: 143–151. doi: 10.1111/j.1360-0443.2010.03118.x
- Issue published online: 10 DEC 2010
- Article first published online: 19 OCT 2010
- Submitted 24 September 2006; initial review completed 10 January 2007; final version accepted 24 June 2010
- Cocaine users;
- hepatitis C;
- non-injecting drug users
Aim To investigate the factors associated with hepatitis C virus (HCV) infection among non-injecting cocaine users (NICUs) and to compare practices associated with HCV and HIV infection.
Design An intercountry cross-sectional study.
Setting Buenos Aires and Montevideo metropolitan areas.
Participants A total of 871 NICUs.
Measurements NICUs were interviewed and their blood was drawn and used for HCV, HIV, HBV surface antigen (HbsAg), HB-anticore and Venereal Disease Research Laboratory (VRDL) antibody assays. Bivariate and multivariate logistic regression analyses included comparisons of HCV and HIV mono-infected participants with HCV–HIV seronegatives.
Findings Prevalence rates were 8.8 [95% confidence interval (CI): 6.9–10.8) for HCV and 7.9 (95% CI: 6.1–9.7) for HIV. HCV-infected NICUs were twice as likely as HCV–HIV seronegatives to have shared straws for cocaine snorting or sniffing, even when adjusted for other variables. HCV prevalence rates ranged from 3.6% among NICUs who denied sharing straws and having had an injection drug user (IDU) or an HIV-positive sexual partner to 12.6% among participants who reported ever having shared straws or having had either an IDU- or HIV-positive sexual partner (χ2trend = 6.56, P = 0.01).
Conclusions Non-injecting cocaine users from South America are vulnerable to multiple infections and HCV infection appears to occur through the sharing of straws. HCV infection is associated with intimate relationships with IDUs or HIV-seropositive partners, supporting the hypothesis that HCV risk may be due primarily to risk-taking behaviour associated with drugs in this population.