"Several studies have demonstrated that non-injection drug users have a higher anti-HCV prevalence than the general population, with estimates ranging from 5 to 29%.6–8 Two studies have found an association between intranasal use of cocaine and anti-HCV,9,10 and researchers have isolated HCV RNA in nasal secretions and implements used for drug inhalation.11 Blood-contaminated non-injection implements such as straws could transmit infection via damaged nasal mucosa.12 Similarly, other research demonstrated low viral titers of HCV in saliva,13 lending plausibility to shared oral drug utensils such as crack pipes as a route of transmission. While some studies have shown an association with sharing non-injection implements or non-injection drug use and HCV infection,1,9,13 others have not shown a significant association.7,14,15"


Keith A. Hermanstyne, David R. Bangsberg, Karen Hennessey, Cindy Weinbaum, Judith A. Hahn, The association between use of non-injection drug implements and hepatitis C virus antibody status in homeless and marginally housed persons in San Francisco, Journal of Public Health, Volume 34, Issue 3, August 2012, Pages 330–339, doi.org/10.1093/pubmed/fds018