Epidemiological aspects of HCV infection in non-injecting drug users in the Brazilian state of Pará, eastern Amazon

Abstract

BackgroundCurrently, sharing of drug paraphernalia is the main form of HCV transmission worldwide. In South America, consistent findings indicate that shared sniffing equipment is an important factor in the spread of HCV among non-injecting drug users. Epidemiological data on the status of HCV infection in illicit drug users in the Amazon region are scarce, although reports of clinical cases of hepatitis or pathologies associated with HCV infection in other population groups are numerous. Thereby, this study investigated the prevalence, genotype frequency, and epidemiological factors associated with HCV infection in non-injecting drug users in the state of Pará, eastern Amazon.ResultsDuring 2008–2011, 300 non-injecting drug users attending drug-treatment centers participated in this study. Most non-injecting drug users were male (63.7%). The mean age was 32.5 years. The non-injecting drugs most consumed were: cannabis (15.6%), cocaine paste (21.3%), and oxi cocaine (25.7%). Tobacco (60.9%) and alcohol (79.4%) were also commonly consumed. One hundred six (35.1%; CI 95%: 29.8 - 41.1) non-injecting drug users presented anti-HCV antibodies by EIA. The HCV-RNA prevalence was 28.0% (95% CI: 20.6 - 35.8). Genotypes 1 (76.9%) and 3 (23.1%) of HCV have been identified. A multivariate analysis demonstrated that HCV infection was independently associated with the following factors: “age (≥ 35 years)”, “tattoos”, “use of a needle or syringe sterilized at home”, “shared use of drug paraphernalia”, “uses drugs for more than 5 years”, and “use of drugs everyday”.ConclusionsThis study revealed a high prevalence of HCV infection in non-injecting drug users, and most infections are occasioned by genotype 1. Likely, HCV transmission is associated with the tattoos, the use of needle or syringe sterilized at home by people over the age of 35 years, and sharing, time and frequency of use of non-injecting drugs. These findings should serve as an incentive for the establishment of a program of Hepatitis C prevention and control by the local public-health authorities in order to develop effective policies and strategies for contain the spread of HCV infection.

Hepatitis C Virus among Female Sex Workers: A Cross-Sectional Study Conducted along Rivers and Highways in the Amazon Region

“…In the Amazon region (northern Brazil), several epidemiological studies indicate a high prevalence of HCV infections and the predominance of genotype 1 in different population groups, such as indigenous people, people living in riverside communities, blood donors, patients undergoing hemodialysis, patients with multiple blood transfusions, and PWUDs [5,18,[20][21][22][23][24][25]. Factors associated with parenteral and sexual exposure to HCV have been detected, including: Shared use of manicure and pedicure instruments, use of home-sterilized needles and syringes, unprotected sexual intercourse, more than 12 sexual partners, daily drug use, drug use for more than three years, and shared use of drug paraphernalia [5,[26][27][28][29]. However, much of the epidemiological information on HCV infection among other vulnerable groups in the Amazon region, such as FSWs, is still unknown.…”

Hepatitis C: clinical and biological features related to different forms of cocaine use

“…30,31 One study with cocaine users found that injecting cocaine users are more likely to have HCV infection than those who deny injection practice. 32 Similarly to general IDUs, higher family income, tattooing, sharing drug paraphernalia, history of drug use for more than 5 years, and daily use of substances of abuse were risk factors to HCV infection among cocaine users. 32 There is also evidence that the sharing of materials for injection other than syringes/needles, like filters and rinse water, contribute substantially to the spread of hepatitis C among IDUs.…”

Patologia das doenças

“…A confecção de tatuagem e a associação uso compartilhado de equipamentos para consumo de drogas e longo tempo de uso de drogas podem estar envolvidas nessas transmissões virais. No Pará, a tatuagem e o compartilhamento de equipamentos para uso de drogas ilícitas é comum, inclusive são variáveis que já foram identificadas como fatores de risco à infecção pelo HCV em Breves (OLIVEIRA-FILHO et al, 2013;OLIVEIRA-FILHO et al, 2014;PACHECO et al, 2014). Por outro lado, as infecções pelo HBV e HIV estão intimamente ligadas à transmissão sexual, como sexo desprotegido e múltiplos parceiros sexuais (FERREIRA et al, 2009;LUM et al, 2008;NEAIGUS et al, 2007).…”

“…Um dos caminhos encontrados pelo Governo Federal para se diminuir a incidência da epidemia de IST, em especial no que tange à transmissão vertical da sífilis e do HIV, dá-se no momento da assistência pré-natal disponibilizada à gestante. Pretendese, por meio da oferta de testes rápidos, realizar o diagnóstico precoce e o tratamento adequado, diminuindo drasticamente os índices nacionais (BRASIL, 2014).…”