"The first shot": the context of first injection of illicit drugs, ongoing injecting practices, and hepatitis C infection in Rio de Janeiro, Brazil

Oliveira, Maria de Lourdes Aguiar; Hacker, Mariana A.; Oliveira, Sheilla Andrade de; Telles, Paulo R.; Ó, Kycia Maria Rodrigues do; Yoshida, Clara Fumiko Tachibana; Bastos, Francisco Inácio

doi:10.1590/s0102-311x2006000400024

Cited by 23 publications

(24 citation statements)

References 42 publications

(56 reference statements)

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“…The factors associated with HCV infection detected in illicit drug users in Breves are similar to those reported in epidemiological studies in different Brazilian municipalities for this risk group [3][4][5][6]11 . Specifi cally, the risk factors for HCV infection are identical to those detected in cocaine users in the State of Pará 11 , thus confi rming the local epidemiological profi le of HCV transmission in illicit drug users.…”

supporting

confidence: 77%

“…In Brazil, epidemiological studies of HCV infection in illicit drug users are still rare. The prevalence of HCV infection in illicit drug users sampled in metropolitan areas in the Northeast, Midwest, South and Southeast regions of Brazil ranged from 5% to 36% [3][4][5][6][7] . There are frequent reports of clinical cases of hepatitis or pathologies associated with HCV infection in other population groups in northern Brazil [8][9][10][11] .…”

mentioning

confidence: 99%

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Prevalence of HCV infection and associated factors among illicit drug users in Breves, State of Pará, northern Brazil

Pacheco

Silva-Oliveira

Maradei-Pereira

et al. 2014

Rev. Soc. Bras. Med. Trop.

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Introduction: Illicit drug users (DUs) are vulnerable to hepatitis C virus (HCV) infection. The shared use of illicit drugs is the main method of HCV transmission. Methods: A cross-sectional study was conducted in Breves, in northern Brazil. We surveyed 187 DUs to determine the prevalence of and factors associated with HCV infection. Results: The prevalence of anti-HCV antibodies was 36.9%, and the prevalence of hepatitis C virus-ribonucleic acid (HCV-RNA) was 31%. Hepatitis C virus infection was associated with tattoos, intravenous drug use, shared use of equipment for drug use, drug use for longer than 3 years, and daily drug use. Conclusions: Strategies for preventing and controlling HCV transmission should be implemented among DUs.Keywords: Hepatitis C virus. Illicit drug users. Northern Brazil.Currently, the sharing of drug paraphernalia is the main transmission method for hepatitis C virus (HCV) worldwide. It is estimated that more than 60% of new HCV infection cases recorded each year are related to the use of illicit drugs, particularly injected drugs 1,2 . In Brazil, epidemiological studies of HCV infection in illicit drug users are still rare. The prevalence of HCV infection in illicit drug users sampled in metropolitan areas in the Northeast, Midwest, South and Southeast regions of Brazil ranged from 5% to 36% 3-7 . There are frequent reports of clinical cases of hepatitis or pathologies associated with HCV infection in other population groups in northern Brazil [8][9][10][11] . It is known that most illicit drug users in Pará do not consume injected drugs and are infected with HCV genotype 1 10,11 . This study estimated the prevalence of HCV infection and assessed the factors associated with HCV infection in illicit drug users in the municipality of Breves, State of Pará, northern Brazil.This cross-sectional study of a non-probabilistic convenience sample was based on information and biological samples provided by illicit drug users in an area of intense illicit drug use located in Breves (01° 40' 55" S 50° 28' 48" O), Archipelago of Marajó, Pará, northern Brazil. Illicit drug users in areas of intense drug consumption were sampled using the snowball technique 11 . Individuals were eligible for the study if they were older than 17 years of age and agreed to answer a specifi c questionnaire and have a blood sample taken and tested for molecular and serologic markers in the period from August to All samples were tested for HCV antibodies and hepatitis C virus-ribonucleic acid (HCV-RNA). Anti-HCV antibodies were tested by enzyme immunoassay (EIA; Murex anti-HCV 4.0, Murex Biotech). HCV RNA was detected by real-time polymerase chain reaction (PCR) using 67 base pairs of the 5' untranslated region (UTR), as described elsewhere 9 . Confi dence intervals (CIs) were determined for infection prevalence estimates. Simple and multiple logistic regressions were calculated to assess the independent effects of variables 12 . The fi t of the fi nal model was assessed using the Hosmer-Lemeshow goodness-of-f...

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supporting

confidence: 77%

mentioning

confidence: 99%

Prevalence of HCV infection and associated factors among illicit drug users in Breves, State of Pará, northern Brazil

Pacheco

Silva-Oliveira

Maradei-Pereira

et al. 2014

Rev. Soc. Bras. Med. Trop.

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“…It also corroborates findings from other international studies that the frequency of equipment sharing was higher at the first injection compared to current sharing habits, and that beginner PWID are frequently engaged in risky injecting behaviors. Studies elsewhere have established that PWID who had shared their injection equipment at the first injection were more likely to repeat this practice over the course of their injection career than those who had injected with new syringes (58.5% versus 16.5%; p = 0.003) [55,56]. Therefore, in Uganda where there is limited access to injecting equipment to cover all injections [16,57,58], the transitioning process becomes more complex and riskier.…”

Section: Discussionmentioning

confidence: 99%

When and how do individuals transition from regular drug use to injection drug use in Uganda? Findings from a rapid assessment

Baluku¹,

Wamala²

2019

Harm Reduct J

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Background: In Uganda, injection drug use is a growing but less studied problem. Preventing the transition to injection drug use may help prevent blood-borne viral transmission, but little is known about when and how people transition to injection drug use. A greater understanding of this transition process may aid in the country's efforts to prevent the continued growth of injection drug use, HIV, and hepatitis C Virus (HCV) infection among people who inject drugs (PWID). Methods: Using a rapid situation assessment framework, we conducted semi-structured interviews among 125 PWID (102 males and 23 females)-recruited through outreach and snow-ball sampling. Participants were interviewed about their experiences on when and how they transitioned into injection drug use and these issues were also discussed in 12 focus groups held with the participants.Results: All the study participants started their drug use career with non-injecting forms including chewing, smoking, and sniffing before transitioning to injecting. Transitioning was generally described as a peer-driven and socially learnt behavior. The participants' social networks and accessibility to injectable drugs on the market and among close friends influenced the time lag between first regular drug use and first injecting-which took an average of 4.5 years. By the age of 24, at least 81.6% (95.7% for females and 78.4% for males) had transitioned into injecting. Over 84.8% shared injecting equipment during their first injection, 47.2% started injecting because a close friend was already injecting, 26.4% desired to achieve a greater "high" (26.4%) which could reflect drug-tolerance, and 12% out of curiosity.Conclusions: Over 81% non-injecting drug users in Kampala and Mbale districts transitioned into injecting by the age of 24; a process that reproduces a population of PWID but also puts them at increased risk of HIV and HCV infection. As Uganda makes efforts to introduce and/or strengthen harm reduction services, interventions targeting non-injecting drug users before they transition into injecting should be considered as a key component for HIV/HCV epidemic control efforts, and their evaluation considered in future researches.

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“…In São Paulo, Silva et al (36) showed a prevalence of 41% among blood donors for this risk factor. Oliveira et al (29) and Smyth et al (37) showed an odds ratio for infection of ~3 for each 10-fold increase in the number of lifetime injecting episodes for those who shared needles/syringes compared to those who injected with sterile ones.…”

Section: Discussionmentioning

confidence: 99%

Viral Hepatitis C in a leading Brazilian hospital: epidemiological factors and genotyping

Bezerra¹,

Lima²,

Vilar³

et al. 2007

Braz. J. Microbiol.

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The hepatitis C virus (HCV) is classified into six different genotypes and their distribution is different throughout the world. Epidemiologic studies are important to determine several characteristics of the virus, as well as the disease. This study analysed the prevalence of HCV and its genotypes among patients from a leading hospital in Ceará, which is located in Northeast Brazil. A total of 119 anti-HCV-seropositive patients, each having previously completed a questionnaire about risk behaviours related to HCV infection were tested for HCV infection using a qualitative HCV polymerase chain reaction (PCR) assay and genotyping by restriction fragment length polymorphism (RFLP). The detection was based on amplifying of the non-coding 5' region. Of the 119 patients, 95 showed positive results in the qualitative HCV test. History of surgery was the most reported risk factor, followed by the use of drugs, having tattoos, undergoing haemodialysis and occupational exposure. Genotype 1 was the most prevalent (46.9%), followed by genotype 3 (34.4%) and 2 (8.3%). The genotype distribution was similar for all of the various risk behaviours.

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"The first shot": the context of first injection of illicit drugs, ongoing injecting practices, and hepatitis C infection in Rio de Janeiro, Brazil

Abstract: The context of first drug injection and its association with ongoing injecting practices and HCV (hepatitis C virus)

Cited by 23 publications

References 42 publications

Prevalence of HCV infection and associated factors among illicit drug users in Breves, State of Pará, northern Brazil

Prevalence of HCV infection and associated factors among illicit drug users in Breves, State of Pará, northern Brazil

When and how do individuals transition from regular drug use to injection drug use in Uganda? Findings from a rapid assessment

Viral Hepatitis C in a leading Brazilian hospital: epidemiological factors and genotyping

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