High prevalence of hepatitis C virus infection among noninjecting drug users: association with sharing the inhalation implements of crack

Liver Int. 2008 Jul;28(6):781-6. doi: 10.1111/j.1478-3231.2008.01688.x.


Background: Most of the prevalent cases of hepatitis C virus (HCV) infection are attributable to intravenous drug using. However, a substantial number of individuals, particularly noninjecting drug users (NIDU), report no identifiable source of HCV exposure. This may be interpreted as inaccurate reporting of past intravenous exposure or as the presence of an unidentified source of HCV infection. Because of this, we evaluated the prevalence of and factors associated with HCV infection among NIDU.

Methods: One hundred and eighty-two individuals who were attended from 2003 to 2004 in a drug addiction facility because of noninjecting drug use were included.

Results: HCV infection was detected in 23 (12.6%) participants. Sharing the inhalation tube of crack cocaine [adjusted odds ratio (AOR) 3.6, 95% confidence interval (CI) 1.3-9.8, P=0.01], presence of tattoos (AOR 3.5, 95% CI 1.3-9.1, P=0.02) and age >or=34 years (AOR 3.9, 95% CI 1.3-11.6, P=0.01) 3.9 were independently associated with HCV infection.

Conclusion: The prevalence of HCV infection in NIDU is higher than in general population. HCV infection is more likely among older drug users, those with tattoos and crack cocaine users that share the inhalation implements.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Adult
  • Bodily Secretions / virology
  • Comorbidity
  • Crack Cocaine / administration & dosage
  • Cross-Sectional Studies
  • Equipment Contamination
  • Female
  • Hepacivirus / genetics
  • Hepacivirus / immunology
  • Hepacivirus / isolation & purification*
  • Hepatitis C / epidemiology*
  • Hepatitis C / transmission
  • Heroin / administration & dosage
  • Humans
  • Male
  • Narcotics / administration & dosage
  • Odds Ratio
  • Prevalence
  • RNA, Viral / analysis
  • Risk-Taking
  • Saliva / virology
  • Sexual Behavior
  • Spain / epidemiology
  • Substance-Related Disorders / epidemiology*
  • Substance-Related Disorders / virology


  • Crack Cocaine
  • Narcotics
  • RNA, Viral
  • Heroin