Hepatitis C virus transmission among oral crack users: viral detection on crack paraphernalia

Eur J Gastroenterol Hepatol. 2008 Jan;20(1):29-32. doi: 10.1097/MEG.0b013e3282f16a8c.


Objective: Epidemiological studies present oral crack use as a potential independent risk factor for hepatitis C virus (HCV) status, yet actual HCV transmission pathways via crack use have not been evidenced. To this end, this exploratory study sought to detect HCV on crack-use paraphernalia used by street crack users.

Methods: Crack-use paraphernalia within 60 min of use was collected from 51 (N) street-crack users. HCV RNA detection was conducted through eluate sampling and manual RNA extraction. Participants provided a saliva sample to test for HCV antibody, and had a digital photograph taken of their oral cavities, to assess the presence of oral sores as a possible risk factor for oral HCV transmission.

Results: About 43.1% (n=22) of the study participants were HCV-antibody positive. One (2.0%) of the 51 pipes tested positive. A minority of the participants presented oral sores. The pipe on which HCV was detected was made from a glass stem; its owner was HCV-antibody positive, and there was full rater agreement on the presence of oral sores in the pipe owner's oral cavity.

Conclusions: HCV transmission from an infected host onto paraphernalia as a precondition of HCV host-to-host transmission via shared crack paraphernalia use seems possible, with oral sores and paraphernalia condition constituting possible risk modifiers. Larger-scale studies with crack users are needed to corroborate our findings.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cocaine-Related Disorders / virology*
  • Crack Cocaine*
  • Equipment Contamination
  • Female
  • Fomites / virology*
  • Hepacivirus / isolation & purification*
  • Hepatitis C / transmission*
  • Humans
  • Male
  • Oral Ulcer / virology*
  • Saliva / chemistry
  • Saliva / virology


  • Crack Cocaine