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.
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Conflict of interest
All authors declare that they have no conflict of interest.
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.
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