Hepatitis C virus among non-injecting cocaine users (NICUs) in South America: can injectors be a bridge?

  1. Waleska T. Caiaffa1,*,
  2. Keli F. Zocratto1,
  3. María L. Osimani2,
  4. Peralta L. Martínez3,
  5. Graciela Radulich4,
  6. Laura Latorre5,
  7. Estela Muzzio6,
  8. Marcela Segura3,
  9. Hector Chiparelli7,
  10. José Russi7,
  11. Jorge Rey8,
  12. Enrique Vazquez9,
  13. Paloma Cuchi9,
  14. Sergio Sosa-Estani3,
  15. Diana Rossi10,
  16. Mercedes Weissenbacher3

Article first published online: 19 OCT 2010

DOI: 10.1111/j.1360-0443.2010.03118.x

Issue

Addiction

Addiction

Volume 106, Issue 1, pages 143–151, January 2011

Additional Information

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

Author Information

  1. 1

    Belo Horizonte Observatory for Urban Health, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil,

  2. 2

    Programa Nacional SIDA, Montevideo, Uruguay,

  3. 3

    Microbiology Department, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina,

  4. 4

    El Retoño Civil Association, Buenos Aires, Argentina,

  5. 5

    IDES, Montevideo, Uruguay,

  6. 6

    CENARESO, Buenos Aires, Argentina,

  7. 7

    Servicio Nacional de Laboratorio de Salud Pública, Montevideo, Uruguay,

  8. 8

    Hospital José de San Martín, Buenos Aires, Argentina,

  9. 9

    PAHO/WHO, WA, USA

  10. 10

    Intercambios Civil Association, Buenos Aires, Argentina

*Waleska T. Caiaffa, Avenue Alfredo Balena, 190 Bairro, Santa Efigênia, CEP 30130-100, Belo Horizonte-MG, Brazil. E-mail: wcaiaffa@medicina.ufmg.br

Publication History

  1. Issue published online: 10 DEC 2010
  2. Article first published online: 19 OCT 2010
  3. Submitted 24 September 2006; initial review completed 10 January 2007; final version accepted 24 June 2010

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Keywords:

  • Cocaine users;
  • hepatitis C;
  • HIV;
  • non-injecting drug users

ABSTRACT

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.

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