Abstract
Over a recent three year period, approximately 600 individuals responded to newspaper advertisements for research studies requiring healthy, cocaine using subjects. These subjects were screened using a standard phone interview in order to eliminate individuals with known medical or psychiatric illnesses that would exclude them from ongoing neuroimaging studies of drug abuse. Individuals were specifically asked about their hepatitis and HIV status. Of these, 170 subjects passed the phone screen, having no known medical or psychiatric illness outside of cocaine abuse/dependence and were willing to be further evaluated for the studies. These subjects were brought to the Medical College of Wisconsin's General Clinical Research Center and tested for, among other measures, hepatitis B, hepatitis C, and HIV. Of these, 144 completed the examination and all testing. In this cohort of assumed healthy subjects, 47 (33%) tested positive for antibodies to the hepatitis C virus (HCV). Only 7 (5%) tested positive for the hepatitis B surface antigen and 2 (1.4%) to HIV. The demographics of this cohort are 56% African-American, 81% male, 75% never-married, 55% unemployed with a mean age of 36 years. The percentage of subjects reporting any lifetime intravenous drug use among the HCV(+) and the HCV(−) cohorts was 77% vs. 29% respectively. Some routes of HCV transmission are still unclear and may reflect lifestyle or other factors related to cocaine use outside of parenteral drug use. Since almost all HCV infections become chronic, and many progress to chronic active hepatitis, cirrhosis, and ultimately hepatocellular carcinoma, these observations suggest a significant epidemic in an unsuspecting population with little regular access to health care. These individuals also form a large pool for the continued transmission of HCV to the general population. Additional public health interventions are suggested.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
Abbott Laboratories (1995). Diagnostics division, Abbott HCV EIA 2.0 circular.
Alter, M.J. (1993). Community acquired viral hepatitis B & C in the United States. Gut, 34 (2 suppl), S17-S19.
Alter, M.J., Margolis, H.S., Krawczynski, K., Judson, F.N., Mares, A., Alexander, W.J., Hu, P.Y, Miller, J.K., Gerber, M.A., Sampliner, R.E., Meeks, E.L. & Beach, M.J. (1992). The natural history of community-acquired hepatitis C in the United States. New England Journal of Medicine, 327, 1899-1905.
Carey, W.D. & Patel, G. (1992). Viral hepatitis in the 1990's, Part l: Current principles of management. Cleveland Clinic Journal of Medicine, 59, 317-325.
Choo, Q-L., Kero, G., Weiner, A.J., Overby, L.R., Bradley, D.W. & Houghton, M. (1989). Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome. Science, 244, 359-362.
Conry-Cantilena, C., VanRaden, M., Gibble, J., Melpolder, J., Shakil, A.O., Viladomin, L., Chenng, L., DiBisceglie, A., Hoofnagle, J., Shih, J.W., Kaslow, R., Ness, R. & Alter, H.J. Routes of infection, viremia, and liver disease in blood donors found to have hepatitis C virus infection. New England Journal of Medicine, 334, 1691-1696.
deCarvalho, H.B., Mesguita, F., Massad, E., Bueno, R.C., Lopes, G.T., Ruiz, M.A. & Burattini, M.N. (1996). HIV and infections of similar transmission patterns in a drug injectors community of Santos, Brazil. Journal of Acquired Immune Deficicency Syndromes & Human Retrovirology, 12, 84-92.
Esteban, J.I., Esteban, R., Viladomiu, L., Lopez-Talavera, J.C., Gonzalez, A., Herrandez, J.M., Roget, M., Vargas, V., Genesca, J., Buti, M., Guaradia, J., Houghton, M., Choo, Q-L. & Kero, G. (1989). Hepatitis C virus antibodies among risk groups in Spain. Lancet, 2(8658), 224-297.
Fingerhood, M.I., Jasinski, D.R. & Sullivan, J.T. (1993). Prevalence of hepatitis C in a chemically dependent population. Archives of Internal Medicine, 153, 2025-2030.
Guadagnino, V., Stroffolini, T., Foca, A., Caroleo, B., Loiacono, L., Giancotti, A., Menniti Ippolito, F. & Piazza, M. (1998). Hepatitis C virus infection in family setting. European Journal of Epidemiology, 14, 229-232.
Hopf, U., Moller, B., Kuther, D., Stemerowicz, R., Lobeck, H. Ludtke-Harrdjerry, A., Walter, E., Blum, H.E., Roggendorf, M. & Deinhart, F. (1990). Long-term follow up of post transfusion and sporatic chronic hepatitis non-A non-B and frequency of circulating antibodies to hepatitis C virus (HCV). Journal of Hepatology, 10, 69-76.
Lee, S.D., Chan, C.Y., Wang, Y.J., Wu, J.C., Lai, K.H., Tsai, Y.T. & Lo, K.J. (1991). Seroepidemiology of hepatitis C virus infection in Taiwan. Hepatology, 13, 830-833.
Mendenhall, C.L., Seeff, L., Diehl, A.M., Ghosn, S.A., French, S.W., Gartside, P.S., Rouster, S.D., Buskell-Bales, Z., Grossman, C.J., Roselle, G.A., Weesner, R.E., Garcia-Pont, P., Goldberg, S.J., Kiernan, T.W., Tamburro, C.H., Zetterman, R., Chedid, A., Chen, T., Rabin, L. & VA Cooperative Study Group #119. (1991). Antibodies to hepatitis B virus and hepatitis C virus in alcoholic hepatitis and cirrhosis: their prevalence and clinical relevance. Hepatology, 14, 581-589.
Ordurra, A., Bratos, M.A., Gutierrez, P., Almaraz, A., Eiros, J.M., Martian, J.F., Gonzalez, J.M., Caro-Patkon, A. & Rodriguez-Torres, A. (1992). Infection in intraveous drug using female prostitutes in Spain. European Journal of Epidemiology, 8, 656-659.
Pirozhkov, S.V., Eskelson, C.D. & Watson, R.R. (1992). Chronic ethanol and cocaine-induced hepatotoxicity: effects of vitamin E supplementation. Alcoholism, Clinical & Experimental Research, 16, 904-909.
Pares, A., Barrera, J.M., Caballeria, J., Ercilla, G., Bruguera, M. & Caballeria, L. (1990). Hepatitis C virus antibodies in chronic alcoholic patients: association with severity of liver injury. Hepatology, 12, 1295-1299.
Robinson, W.S. (1995). Hepatitis B virus and hepatitis D virus. In: Principles and practice of infectious disease, Mandell, G.L., Bennett, J.E. & Dolin, R. (eds.), pp. 1406-1429. New York: Churchill Livingstone, Inc.
Scheurer, P.J., Ashrafzaadeh, P., Sherlock, S., Brown, D. & Dusheiko, G.M. (1992). The pathology of hepatitis C. Hepatology, 15, 567-571.
Thomas, D.L., O'Connor, R., Shapiro, C.N., Hook III, E.W., Alter, M.J. & Quinn, T.C. (1994). Hepatitis C, hepatitis B and human immunodeficiency virus infections among non-intravenous drug using patients attending clinics for sexually transmitted diseases. Journal of Infectious Disease, 169, 990-995.
VandenHolk, J.A., VanHaastrecht, H.J., Goudsmit, J., deWolf, F. & Continlio, R.A. (1990). Prevalence, incidence and risk factors of hepatitis C virus infections among drug users in Amsterdam. Journal of Infectious Disease, 162, 823-826.
Wiley, T.E., McCarthy, M., Breidi, L. & Layden, T.J. (1998). Impact of alcohol on the histological and clincial progression of hepatitis C infection. Hepatology, 28, 805-809.
Woodfield, D.G., Harness, M., Rix-Trott, K., Tsuda, F., Okamoto, H. & Mayumi, M. (1994). Identification and genotyping of hepatitis C virus in injectable and oral drug users in New Zealand. New Zealand Journal of Medicine, 24, 47-50.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Harsch, H.H., Pankiewicz, J., Bloom, A.S. et al. Hepatitis C Virus Infection in Cocaine Users—A Silent Epidemic. Community Ment Health J 36, 225–233 (2000). https://doi.org/10.1023/A:1001988613235
Issue Date:
DOI: https://doi.org/10.1023/A:1001988613235