Intranasal cocaine use does not appear to be an independent risk factor for HCV infection

To determine the prevalence of HCV infection among intranasal cocaine users and evaluate underlying parental risk factors.

A cross-sectional study evaluated prospectively 60 patients admitted to a chemical dependency unit.

A standardized questionnaire was designed to obtain epidemiological data. Aminotransferases and anti-HCV antibodies were determined. Anti-HCV antibody positivity was confirmed by polymerase chain reaction (PCR).

Fifteen (25%) patients of 60 tested intranasal cocaine users were anti-HCV positive. Ten (75%) of them had detectable HCV-RNA. Comparison between 15 anti-HCV positive and 45 anti-HCV negative patients showed significant differences in mean age (35 versus 27 years), estimated time of drug use (10 versus 4 years), rate of elevated ALT and/or AST (60% versus 16%) and presence of parenteral risk factors (100% versus 7%). Comparison between patients with and without elevated aminotransferases showed significant difference in mean duration of drug use (8 versus 5 years) and rate of anti-HCV positivity (56% versus 14%). Among 15 anti-HCV positive patients, HCV-RNA was detectable in all with elevated aminotransferases and only one of six with normal aminotransferases (100% versus 17%).

While there was a high prevalence of anti-HCV antibodies in this sample of intranasal cocaine users, the infection was highly correlated with the presence of intravenous (i.v.) drug use and duration of drug use. In this sample, therefore, intranasal cocaine use alone was not an important risk factor for HCV infection.