Molecular and epidemiological aspects of hepatitis C virus infection among crack cocaine users

Abstract

The aim is to investigate the prevalence, risk factors, and hepatitis C virus (HCV) genotypes/subtypes among crack users in‐treatment in Central Brazil. A cross‐sectional survey in which 600 in‐treatment crack users were interviewed and tested for anti‐HCV Ab by enzyme‐linked immunosorbent assay was conducted between August 2012 and April 2013. Anti‐HCV‐positive samples were also submitted for HCV RNA detection by polymerase chain reaction. Positive HCV RNA samples were genotyped by direct sequencing analysis of the NS5B region of the viral genome, followed by phylogenetic analysis. Of the total, 3.7% (95.0% CI, 2.4%‐5.6%) were anti‐HCV positive. Age over 40 years and history of injecting drugs were risk factors for HCV, while snorting cocaine was a protector variable. HCV RNA was detected in 14 of 22 anti‐HCV‐positive samples, and the genotypes 1 (n = 10) and 3 (n = 2), subtypes 1a (n = 7), 1b (n = 3), and 3a (n = 2) were identified. The HCV prevalence found among crack users is almost threefold that observed in the general population in Brazil supporting that this population is at higher risk for HCV. The findings of cocaine insufflation as a protective behavior for HCV infection in this population should be explored.

High prevalence of Hepatitis C Virus infection among people who use crack cocaine in an important international drug trafficking route in Central-West Region Brazil

“…Conversely, it was similar to that found in other studies conducted among PWUC in Brazil (Bastos and Bertoni, 2014;Del-Rios et al, 2019;Nunes et al, 2007a;de Sá et al, 2013;Santos Cruz et al, 2013a, 2013b, and lower than frequencies reported from studies conducted in other countries among individuals who do not inject drugs, which has been documented as high as 35.2% (Inciardi et al, 2006a;Nelson et al, 2011). Studies reporting high prevalence (> 20%) tended to have small to modest sample sizes (n = 20 to 260; median = 83) and took place in East Asia, which is one of the regions with a higher prevalence of HCV infection and a great number of people who inject drugs (PWID) (von Diemen et al, 2010b).…”

“…The genotypes found in this study (genotype 1a followed by genotype 3a and 1b) are consistent with those previously found in Brazil (Campiotto et al, 2005;Lampe et al, 2013;Mendes-Correa et al, 2008), among PWUC (Del-Rios et al, 2019;Lopes et al, 2009) and other groups infected with HCV in the same region (Freitas et al, 2014b;Martins et al, 2006). No significance difference was found between intra-host HCV divergence and HCV RNA levels, age, time of drug use, or other variable collected.…”

Drug consumption rooms are effective to reduce at‐risk practices associated with HIV/HCV infections among people who inject drugs: Results from the COSINUS cohort study

“…These results all corroborate the findings of other studies on precarity [31] and daily injection [32, 33]. Stimulants use [34] especially crack cocaine use, are associated with an increase of HCV prevalence; that is, a threefold prevalence in Brazil compared to the general population [35, 36] and higher prevalence among crack cocaine users to opioid users among vulnerable groups in other settings, including France [37, 38]. More surprisingly, in our cohort declaring to be HCV‐positive is also associated with sharing injection equipment.…”