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

Abstract

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.

Hepatitis C antibody testing in African American and Hispanic men in New York City with prostate biopsy

“…Elevation of liver transaminases is the most likely explanation as to why this testing was ordered and high rates of prostate cancer in men without hepatitis C antibody present suggest there may be a relationship between the risk factors for hepatitis C exposure and prostate cancer pathogenesis. Hepatitis C has been linked to direct exposure to infected blood through transfusions [8], intravenous drug abuse [9], tattooing [10], sexual exposure [11] and inhalational cocaine use, through the sharing of nasal straws [12]. In men with evidence of hepatitis C antibody the approximate 70% rate of prostate cancer raises the question of hepatitis C as one potential causal mechanism for prostate cancer.…”

Epidemic history of major genotypes of hepatitis C virus in Uruguay

“…It has been estimated that around 0.4% of Uruguayan blood bank donors population is seropositive for HCV (DLSP, 2002) but it can increase up to 8.8% in non-injecting drug users (Caiaffa et al, 2011) and 10.1% in intravenous drug users (Osimani et al, 2005). There is no data published about the most prevalent HCV genotypes circulating in Uruguay and their evolutionary and demographic history.…”

Commentary on Caiaffa et al. (2011): The renewed challenge of hepatitis C virus epidemiology among non-injecting drug users

“…The precise role of each one of these factors remains a challenge for epidemiologists and molecular biologists. The paper by Caiaffa et al provides consistent evidence about the role of shared straws in the spread of HCV among a pool of non-injecting drug users from Argentina and Uruguay, and also highlights the relevance of their interactions with injecting drug users and/or people living with HIV/AIDS, basically in the context of shared drug use [2].…”

“…the exposure of susceptible patients' blood to contaminated blood) is pivotal to the spread of hepatitis C and has been documented by a comprehensive literature in the field of epidemiology and molecular biology [2][3][4]8]. Notwithstanding, a substantial share of both chronic carriers and recently infected individuals have no history of parenteral exposure due either to blood transfusions (or organ transplants) or to the shared used of injection paraphernalia.…”

“…The recent papers by Caiaffa et al [2] and Romano et al [3], written from different perspectives and using different analytical methods, represent seminal contributions towards a better understanding of such a major public health problem, a condition that currently affects 130-170 million people world-wide [4]. Caiaffa et al's paper addresses a key population in the spread of hepatitis C virus (HCV) infection-non-injecting drug users.…”