title: Non-injection drug use and Hepatitis C Virus: a systematic review.
abstract: This systematic review examined the evidence on the prevalence of the Hepatitis C Virus (HCV) in non-injecting drug users (NIDUs) who sniff, smoke or snort drugs such as heroin, cocaine, crack or methamphetamine. The search included studies published from January 1989 to January 2006. Twenty-eight eligible studies were identified and the prevalence of HCV in these NIDU populations ranged from 2.3 to 35.3%. There was substantial variation in study focus and in the quality of the NIDU data presented in the studies. The results of our systematic review suggested that there are important gaps in the research of HCV in NIDUs. We identified a problem of study focus; much of the research did not aim to study HCV in users of non-injection drugs. Instead, NIDUs were typically included as a secondary research concern, with a principal focus on the problem of transmission of HCV in IDU populations. Despite methodological issues, HCV prevalence in this population is much higher than in a non-drug using population, even though some IDUs might have inadvertently been included in the NIDU samples. These studies point to a real problem of HCV in NIDU populations, but the causal pathway to infection remains unclear.
authors.affiliation: Center for Drug Use and HIV Research, National Development and Research Institutes (NDRI), 71 West 23rd Street, 8th Floor, New York, NY 10010, United States. Scheinmann@ndri.org
authors.forename: Roberta
authors.initials: R
authors.lastname: Scheinmann
authors.forename: Holly
authors.initials: H
authors.lastname: Hagan
authors.forename: Corina
authors.initials: C
authors.lastname: Lelutiu-Weinberger
authors.forename: Rebecca
authors.initials: R
authors.lastname: Stern
authors.forename: Don C
authors.initials: DC
authors.lastname: Des Jarlais
authors.forename: Peter L
authors.initials: PL
authors.lastname: Flom
authors.forename: Shiela
authors.initials: S
authors.lastname: Strauss
mesh_terms: D015984:Causality; D003430:Cross-Sectional Studies; D006306:Health Surveys; D006526:Hepatitis C / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014481:United States