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Research Finds Hepatitis C Spreads Via Shared Straws

Craig Towers, MD, Professor of Obstetrics and Gynecology in the Division of Maternal-Fetal Medicine, has found evidence that the sharing of snorting utensils, such as straws, when abusing illicit drugs can transmit Hepatitis C (HCV) and other blood-borne viruses like HIV from person to person.

The results of this research have been published in Obstetrics & Gynecology, the official publication of the American College of Obstetricians & Gynecologists and are also available via PubMed.

“This is a worldwide issue that needs to be addressed,” said Dr. Towers.

“The idea that ‘if you snort, don’t share straws’ needs to be communicated around the globe as the use of snorting straws for drug-use is a common practice, especially for those that prefer that method over intravenous drug use,” said Dr. Towers.

According to Dr. Towers, the national impact of the study is of particular interest as the most common chronic blood-borne infection in the United States is HCV. Since his study was conducted on women living in the greater Eastern Tennessee region, the study supports previous stats proving the overwhelming existence of an “opioid epidemic,” especially in Appalachia.

“Previous reports have shown a 364% increase in HCV infections from 2006 to 2012 in the central Appalachian region,” said Dr. Towers. “The main concern is the transmission of any blood-borne virus, but a huge potential impact of the sharing of snorting utensils is the threat of transmitting HIV, which is more serious than HCV. If HIV were to enter the blood pool of this population, an increase in this serious infection might also develop.”

In the 16-month study (March of 2014 through June of 2016), Dr. Towers’ goal was to evaluate possible modes of HCV acquisition in HCV-infected pregnant patients in Eastern Tennessee through known common routes such as intravenous drug usage, blood transfusion, organ transplant, sexual contact, and tattoos, as well as possible straw transmission. Therefore, an anonymous survey was distributed to 189 women who had tested positive for HCV post-routine blood testing at Dr. Towers’ obstetrics clinic at the medical center.

“Because of the high rates of HCV-infections we’ve seen, HCV testing has become part of the routine prenatal screening at High Risk Obstetrical Consultants,” said Dr. Towers.

Dr. Towers explains this group of pregnant women was specifically chosen for the study because pregnancy provides a population that is often more motivated for healthcare intervention due to the potential effects on the unborn child.

According to Dr. Towers, of the study’s 189 participants, 133 participants (70%) did not have any idea when they had become infected with HCV and 127 (67%) were first told they had HCV following the prenatal lab work that was obtained during routine prenatal care. Additionally, of the women surveyed, 164 (92%) reported sharing snorting straws.

“Nearly all participants reported that opiates were the primary drug that was snorted,” said Dr. Towers. “In addition, the opiates used intravenously and snorted in the Appalachian region are crushed prescription drugs, which is evidence of the neonatal abstinence syndrome (NAS) epidemic that also exists in our region and has been the basis of some of my previous research studies.”

Dr. Towers concludes that the sharing of snorting straws in the process of snorting opiates or any other drugs may be an additional risk factor for becoming infected with HCV and other blood-borne infections.

“This risk needs to be communicated to the public and the healthcare community,” said Dr. Towers.

Dr. Towers says the next phase of his research will study the risk of HCV being transmitted to babies during birth.


Posted December 13, 2016

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