Hepatitis C virus transmission among oral crack users: viral detection on crack paraphernalia.
OBJECTIVE
Epidemiological studies present oral crack use as a potential independent risk factor for hepatitis C virus (HCV) status, yet actual HCV transmission pathways via crack use have not been evidenced. To this end, this exploratory study sought to detect HCV on crack-use paraphernalia used by street crack users.


METHODS
Crack-use paraphernalia within 60 min of use was collected from 51 (N) street-crack users. HCV RNA detection was conducted through eluate sampling and manual RNA extraction. Participants provided a saliva sample to test for HCV antibody, and had a digital photograph taken of their oral cavities, to assess the presence of oral sores as a possible risk factor for oral HCV transmission.


RESULTS
About 43.1% (n=22) of the study participants were HCV-antibody positive. One (2.0%) of the 51 pipes tested positive. A minority of the participants presented oral sores. The pipe on which HCV was detected was made from a glass stem; its owner was HCV-antibody positive, and there was full rater agreement on the presence of oral sores in the pipe owner's oral cavity.


CONCLUSIONS
HCV transmission from an infected host onto paraphernalia as a precondition of HCV host-to-host transmission via shared crack paraphernalia use seems possible, with oral sores and paraphernalia condition constituting possible risk modifiers. Larger-scale studies with crack users are needed to corroborate our findings.
Fischer
Benedikt
B
Centre for Addictions Research of British Columbia, Victoria, Canada. Bfischer@Uvic.ca
Powis
Jeff
J
Firestone Cruz
Michelle
M
Rudzinski
Katherine
K
Rehm
Jürgen
J
D019970:Cocaine-Related Disorders / Q000821:virology*; D016578:Crack Cocaine; D004866:Equipment Contamination; D005260:Female; D050456:Fomites / Q000821:virology*; D016174:Hepacivirus / Q000302:isolation & purification*; D006526:Hepatitis C / Q000635:transmission*; D006801:Humans; D008297:Male; D019226:Oral Ulcer / Q000821:virology*; D012463:Saliva / Q000737:chemistry / Q000821:virology
D016578:Crack Cocaine