A study in New York City has found a higher than expected prevalence of hepatitis C infection among non-injecting drug users. In this study, as many as 17 percent of the subjects who denied a history of injection drug use were found to be infected, compared to a 2 percent infection rate in the general population. Among women from one of the study sites in East Harlem who reported use of non-injection heroin, the rate of infection was as high as 26 percent.
The findings, published in the May 1 issue of Substance Use & Misuse, may indicate that use of needles and syringes is not the only drug-related risk factor for HCV.
Currently, about 60 percent of all new cases of HCV infection in the U.S. are attributable to syringe and needle-sharing with an infected individual. Dr. Alan I. Leshner, NIDA Director, says this study demonstrates that "We need to look closer for other routes of HCV transmission among non-injecting drug-users. If hepatitis C can be transmitted through the sharing of non-injecting drug paraphernalia such as straws or pipes, we need to include this information in public health messages targeted to this population."
Dr. Stephanie Tortu, from the Tulane University School of Public Health and Tropical Medicine, in collaboration with Dr. Alan Neaigus of the National Development and Research Institutes, Inc. in New York City, conducted two separate studies with self-reported non-injecting drug users recruited from two NYC neighborhoods. The study participants either denied ever injecting drugs or reported that they had not injected drugs within the past six months prior to participating in the study.
Of 107 women and 251 men from the Lower East Side of Manhattan who reported never injecting, 14 percent of the women and 18 percent of the men were found to be infected with hepatitis C. Of the 171 women in the East Harlem sample who reported no history of injection drug use, 17 percent were found to be infected.
These rates, while lower than for those who had reported histories of injection drug use, were higher than those found in the general population. Of those who had reported past injection drug use, more than half of the men and women in the sample from the Lower East Side, and 62 percent of the women from East Harlem, were infected.
"These studies indicate that the prevalence of HCV among drug users who report that they have never injected is substantially higher than for the general population in the U.S. and several other countries, and prevalence may vary according to population, gender, age, and drugs used," says Dr. Tortu. "Further research is needed to determine the risk factors for HCV transmission among those with no history of injecting drugs."