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


METHODS
An intercountry cross-sectional study. Setting  Buenos Aires and Montevideo metropolitan areas.


METHODS
A total of 871 NICUs.


METHODS
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.


RESULTS
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 (χ(2) (trend)  = 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.
Belo Horizonte Observatory for Urban Health, Federal University of Minas Gerais, Belo Horizonte, Brazil. wcaiaffa@medicina.ufmg.br
Waleska T
WT
Caiaffa
Keli F
KF
Zocratto
María L
ML
Osimani
Peralta L
PL
Martínez
Graciela
G
Radulich
Laura
L
Latorre
Estela
E
Muzzio
Marcela
M
Segura
Hector
H
Chiparelli
José
J
Russi
Jorge
J
Rey
Enrique
E
Vazquez
Paloma
P
Cuchi
Sergio
S
Sosa-Estani
Diana
D
Rossi
Mercedes
M
Weissenbacher
D000293:Adolescent; D000328:Adult; D001118:Argentina / Q000453:epidemiology; D003042:Cocaine / Q000008:administration & dosage*; D019970:Cocaine-Related Disorders / Q000150:complications / Q000453:epidemiology*; D015897:Comorbidity; D004812:Epidemiologic Methods; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006509:Hepatitis B / Q000453:epidemiology; D006526:Hepatitis C / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D008297:Male; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology*; D014505:Urban Population / Q000706:statistics & numerical data; D014583:Uruguay / Q000453:epidemiology
D003042:Cocaine