Non-injection drug use and Hepatitis C Virus: A systematic review

Center for Drug Use and HIV Research, National Development and Research Institutes (NDRI), 71 West 23rd Street, 8th Floor, New York, NY 10010, United States.
Drug and Alcohol Dependence (Impact Factor: 3.28). 07/2007; 89(1):1-12. DOI: 10.1016/j.drugalcdep.2006.11.014
Source: PubMed

ABSTRACT This systematic review examined the evidence on the prevalence of the Hepatitis C Virus (HCV) in non-injecting drug users (NIDUs) who sniff, smoke or snort drugs such as heroin, cocaine, crack or methamphetamine. The search included studies published from January 1989 to January 2006. Twenty-eight eligible studies were identified and the prevalence of HCV in these NIDU populations ranged from 2.3 to 35.3%. There was substantial variation in study focus and in the quality of the NIDU data presented in the studies. The results of our systematic review suggested that there are important gaps in the research of HCV in NIDUs. We identified a problem of study focus; much of the research did not aim to study HCV in users of non-injection drugs. Instead, NIDUs were typically included as a secondary research concern, with a principal focus on the problem of transmission of HCV in IDU populations. Despite methodological issues, HCV prevalence in this population is much higher than in a non-drug using population, even though some IDUs might have inadvertently been included in the NIDU samples. These studies point to a real problem of HCV in NIDU populations, but the causal pathway to infection remains unclear.

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Available from: Don C Des Jarlais, Feb 20, 2014
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    • "People who smoke crack experience disproportionately high levels of morbidity, such as chronic and infectious diseases, physical health problems, and mental health challenges (Falck et al., 2004; Fischer & Coghlan, 2007), even in comparison to other drug-using populations (Fischer et al., 2006). Crack smoking is independently associated with HIV and hepatitis C (HCV) infection (DeBeck et al., 2009; Roy et al., 2001), and the incidence of HIV and HCV among crack-smoking populations has been documented to be as high as 7.5% and 35.3%, respectively (Kral et al., 1998; Scheinmann et al., 2007). Crack-smoking populations are also severely socially marginalized, and disproportionately impacted by intersecting social inequities that function to increase their exposure to violence and compromise their health (Bungay, Johnson, Varcoe, & Boyd, 2010; Fischer & Coghlan, 2007). "
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    • "HIV and HCV acquisition among substance users have historically been associated with injection drug use and risky sexual behaviors . More recent research, however, has also found a correlation between noninjection drug use and increased risk for HIV and HCV (Strathdee and Sherman, 2003; Neaigus et al., 2007; Scheinmann et al., 2007), making risk-behavior prevention critical for all substance abusers. This increased risk for HIV and HCV is particularly serious among prescription opioid (PO) abusers. "
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    • "With regard to prescription opioids, users may crush the pills into particles small enough for insufflation ( " snorting " ), or crush and dissolve the pills for injection ( " shooting " ; Raffa and Pergolizzi, 2010). Administration of drugs in either manner is accompanied by increased health risks, such as overdose, or the transfer of communicable disease (Green et al., 2011; Scheinmann et al., 2007; Surratt et al., 2011; Martinez and Talal, 2008; Macias et al., 2008). To counter medication-tampering techniques that may lead to behaviors that are accompanied by such health risks, a great deal of attention is being paid to drug formulation technologies that may deter abuse (Coleman et al., 2005, 2010; Cone, 2006; Hamed and Moe, 2010; Katz et al., 2011). "
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