Archives of Virology

, Volume 163, Issue 3, pp 617–622 | Cite as

Hepatitis C virus infection among illicit drug users in an archipelago of the Amazon

  • Fabricio Q. Silva
  • Francisco J. A. Santos
  • Andreia P. Andrade
  • Suzy D. B. Pacheco
  • Benedikt Fischer
  • João Renato R. Pinho
  • José Alexandre R. Lemos
  • Aldemir B. Oliveira-Filho
Original Article


Hepatitis C virus (HCV) infection causes acute and chronic liver disease and may lead to cirrhosis, liver failure or hepatocellular carcinoma. The behavior of illicit drug users (DUs) typically exposes them to risks of viral infection. In the Brazilian Amazon region, a number of studies have identified high rates of drug use among adolescents, and a high prevalence of HBV infection in DUs, disseminated by sexual and parenteral activities. However, the epidemiological scenario of HCV infection in the region is still poorly understood. This study determined the prevalence, genotypes, and risk factors for HCV infection among DUs of the Marajó Archipelago. This cross-sectional study collected samples and epidemiological information from DUs in 11 municipalities. The diagnosis was established by EIA and real-time PCR, and the samples were genotyped by multiplex real time PCR. The data were analyzed by simple and multiple logistical regression. In 466 DUs, 28.3% had anti-HCV antibodies, and 25.5% had HCV-RNA. In 92 injecting drug users, 88.0% had anti-HCV antibodies, and 80.4% had HCV-RNA. Genotypes 1 and 3 were detected, with three cases of mixed infections. The multivariate analysis indicated associations of HCV infection with age (≥ 35 years), tattoos, intravenous drug use, shared use of injection equipment, and the daily and long-term (> 3 years) use of illicit drugs. These findings will contribute to the development of effective measures for the prevention of HCV infection among Brazilian DUs, as well as its general population.


Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Financial support

This study was supported by Brazilian institutions: Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ—475142/2013-6), Ministério da Saúde/Secretaria de Vigilância em Saúde (MS/SVS—25000.201634/2013-31), and Pró-Reitoria de Pesquisa e Pós-Graduação da Universidade Federal do Pará (UFPA-PRODOUTOR 2012). Fabricio Q. Silva, Francisco J. A. Santos, Andreia P. Andrade, and Suzy D. B. Pacheco received scholarships PIBIC-CNPQ and PIBIC-UFPA to develop this study.


All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All participants signed informed consent term and clarified. All participants signed questionnaire with answers to population characterization and determination of factors associated with viral infections. All study participants received their results of laboratory tests. Participants with viral infections were directed to reference centers for counseling and treatment in the state of Pará, Brazil. This study was approved by the Ethical in Research Committee of the Núcleo de Medicina Tropical of the Universidade Federal do Pará, Belém PA, Brazil.


  1. 1.
    Andrade AP, Pacheco SD, Silva FQ et al (2017) Characterization of hepatitis B virus infection in illicit drug users in the Marajó Archipelago, northern Brazil. Arch Virol 162:227–233. CrossRefPubMedGoogle Scholar
  2. 2.
    Confalonieri UEC (2005) Saúde na Amazônia: um modelo conceitual para a análise de paisagens e doenças. Estud Av 19:221–236. CrossRefGoogle Scholar
  3. 3.
    De Paula VS, Arruda ME, Vitral CL, Gaspar AM (2001) Seroprevalence of viral hepatitis in riverine communities from the western region of the Brazilian Amazon Basin. Mem Inst Oswaldo Cruz 96:1123–1128. CrossRefPubMedGoogle Scholar
  4. 4.
    Duailibi LB, Ribeiro M, Laranjeira R (2008) Profile of cocaine and crack users in Brazil. Cad Saude Publica 24:545–557. CrossRefGoogle Scholar
  5. 5.
    Ferrari JO, Ferreira MU, Tanaka A, Mizokami M (1999) The seroprevalence of hepatitis B and C in an Amerindian population in the southwestern Brazilian Amazon. Rev Soc Bras Med Trop 32:299–302CrossRefPubMedGoogle Scholar
  6. 6.
    Furtado IM, Araujo LG, Almeida JM et al (2017) Use of marijuana and cocaine among students in the municipality of Breves, Marajó Archipelago, Brazilian Amazon. J Drug Abuse 3:1. CrossRefGoogle Scholar
  7. 7.
    Grupo de Estudo e Pesquisa Trabalho e Desenvolvimento na Amazônia, Universidade Federal do Pará (2012) Relatório Analítico do Território do Marajó. Disponível em: Accessed 2 July 2014
  8. 8.
    Lopes CL, Teles SA, Espírito-Santo MP et al (2009) Prevalence, risk factors and genotypes of hepatitis C virus infection among drug users, Central-Western Brazil. Rev Saude Publica 43:43–50. CrossRefPubMedGoogle Scholar
  9. 9.
    Nelson PK, Mathers BM, Cowie B et al (2011) Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews. Lancet 13(378):571–583. CrossRefGoogle Scholar
  10. 10.
    Norouzian H, Gholami M, Shakib P et al (2016) Prevalence of HCV infections and co-infection with HBV and HIV and associated risk factors among addicts in Drug Treatment Centers, Lorestan Province, Iran. Int J High Risk Behav Addict 5:e25028. CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Novais AC, Lopes CL, Reis NR et al (2009) Prevalence of hepatitis C virus infection and associated factors among male illicit drug users in Cuiabá, Mato Grosso, Brazil. Mem Inst Oswaldo Cruz 104:892–896. CrossRefPubMedGoogle Scholar
  12. 12.
    Oliveira ML, Yoshida CF, Telles PR et al (2009) Trends in HCV prevalence, risk factors and distribution of viral genotypes in injecting drug users: findings from two cross-sectional studies. Epidemiol Infect 137:970–979. CrossRefPubMedGoogle Scholar
  13. 13.
    Oliveira-Filho AB, Pimenta Ado S, Rojas Mde F et al (2010) Likely transmission of hepatitis C virus through sharing of cutting and perforating instruments in blood donors in the State of Pará, Northern Brazil. Cad Saude Publica 26:837–844. CrossRefPubMedGoogle Scholar
  14. 14.
    Oliveira-Filho AB, Pimenta AS, Rojas MF et al (2010) Prevalence and genotyping of hepatitis C virus in blood donors in the state of Pará, Northern Brazil. Mem Inst Oswaldo Cruz 105:103–106. CrossRefPubMedGoogle Scholar
  15. 15.
    Oliveira-Filho AB, Sawada L, Pinto LC et al (2013) HCV infection among cocaine users in the state of Pará, Brazilian Amazon. Arch Virol 158:1555–1560. CrossRefPubMedGoogle Scholar
  16. 16.
    Oliveira-Filho AB, Sawada L, Pinto LC et al (2014) Epidemiological aspects of HCV infection in non-injecting drug users in the Brazilian state of Pará, eastern Amazon. Virol J 11:38. CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Pacheco SD, Silva-Oliveira GC, Maradei-Pereira LM et al (2014) Prevalence of HCV infection and associated factors among illicit drug users in Breves, State of Pará, northern Brazil. Rev Soc Bras Med Trop 47:367–370. CrossRefPubMedGoogle Scholar
  18. 18.
    Pereira LM, Martelli CM, Moreira RC et al (2013) Prevalence and risk factors of Hepatitis C virus infection in Brazil, 2005 through 2009: a cross-sectional study. BMC Infect Dis 13:60. CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Pinheiro LM, Lima DJF, Amaral CEM et al (2014) Sexually transmitted infections among female sex workers in riverside communities in the Marajó Archipelago. Brazilian Amazon. J Int AIDS Soc 17(2 Suppl 1):19180. Google Scholar
  20. 20.
    Prati D (2006) Transmission of hepatitis C virus by blood transfusions and other medical procedures: a global review. J Hepatol 45:607–616. CrossRefPubMedGoogle Scholar
  21. 21.
    Rolfe KJ, Alexander GJ, Wreghitt TG, Parmar S, Jalal H, Curran MD (2005) A real-time Taqman method for hepatitis C virus genotyping. J Clin Virol 34:115–121. CrossRefPubMedGoogle Scholar
  22. 22.
    Santos Cruz M, Andrade T, Bastos FI et al (2013) Key drug use, health and socio-economic characteristics of young crack users in two Brazilian cities. Int J Drug Policy 24:432–438. CrossRefPubMedGoogle Scholar
  23. 23.
    Sawada L, Pinheiro AC, Locks D et al (2011) Distribution of hepatitis C virus genotypes among different exposure categories in the State of Pará, Brazilian Amazon. Rev Soc Bras Med Trop 44:8–12. CrossRefPubMedGoogle Scholar
  24. 24.
    Shepard CW, Finelli L, Alter MJ (2005) Global epidemiology of hepatitis C virus infection. Lancet Infect Dis 5:558–567. CrossRefPubMedGoogle Scholar
  25. 25.
    Shepard CW, Simard EP, Finelli L et al (2006) Hepatitis B virus infection: epidemiology and vaccination. Epidemiol Rev 28:112–125. CrossRefPubMedGoogle Scholar
  26. 26.
    Silva MB, Andrade TM, Silva LK et al (2010) Prevalence and genotypes of hepatitis C virus among injecting drug users from Salvador-BA, Brazil. Mem Inst Oswaldo Cruz 105:299–303. CrossRefPubMedGoogle Scholar
  27. 27.
    Soares MC, Menezes RC, Martins SJ, Bensabath G (1994) Epidemiology of hepatitis B, C and D viruses among the Parakanã Tribe in the Eastern Brazilian Amazon Region. Bol Oficina Sanit Panam 117:124–135PubMedGoogle Scholar
  28. 28.
    Te HS, Jensen DM (2010) Epidemiology of hepatitis B and C viruses: a global overview. Clin Liver Dis 14:1–21. CrossRefPubMedGoogle Scholar
  29. 29.
    Thomson BJ (2009) Hepatitis C virus: the growing challenge. Br Med Bull 89:153–167. CrossRefPubMedGoogle Scholar
  30. 30.
    Vallinoto AC, Aguiar S, Sá KG et al (2016) Prevalence and risk behaviour for human immunodeficiency virus 1 infection in Marajó Island, Northern Brazil. Ann Hum Biol 43:397–404. CrossRefPubMedGoogle Scholar
  31. 31.
    Valois RC, Maradei-Pereira LMC, Crescente JÂ, Oliveira-Filho AB, Lemos JA (2014) HCV infection through perforating and cutting material among candidates for blood donation in Belém, Brazilian Amazon. Rev Inst Med Trop Sao Paulo 56:511–515. CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Von Diemen L, De Boni R, Kessler F, Benzano D, Pechansky F (2010) Risk behaviors for HCV- and HIV-seroprevalence among female crack users in Porto Alegre, Brazil. Arch Womens Ment Health 13:185–191. CrossRefGoogle Scholar
  33. 33.
    Zocratto KB, Caiaffa WT, Proietti FA et al (2006) HCV and HIV infection and co-infection: injecting drug use and sexual behavior, AjUDE-Brasil I Project. Cad Saude Publica 22:839–848. CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2017

Authors and Affiliations

  • Fabricio Q. Silva
    • 1
  • Francisco J. A. Santos
    • 1
  • Andreia P. Andrade
    • 1
  • Suzy D. B. Pacheco
    • 1
  • Benedikt Fischer
    • 2
    • 3
  • João Renato R. Pinho
    • 4
  • José Alexandre R. Lemos
    • 5
  • Aldemir B. Oliveira-Filho
    • 1
  1. 1.Group of Study and Research in Vulnerable Populations (GEPPoV), Institute of Coastal Studies, Campus of BragançaFederal University of ParáBragançaBrazil
  2. 2.Department of Psychiatry, Centre for Addiction and Mental HealthUniversity of TorontoTorontoCanada
  3. 3.Department of PsychiatryFederal University of Sao PauloSão PauloBrazil
  4. 4.Institute of Tropical MedicineUniversity of São PauloSão PauloBrazil
  5. 5.Institute of Biological SciencesFederal University of ParáBelémBrazil

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