Egypt is one of the most famous endemic areas for hepatitis C virus. Drug use in Egypt is rising exponentially. Drug use is always considered one of the main risk factors for HCV.

To assess the effect the route of drug use on the incidence of HCV in the Egyptian population.

To study the effects of opiates (tramadol and heroin) use and the route of intake on the incidence of HCV infection among addicts treated in Mamoura mental state hospital, Alexandria, Egypt.

This is a cross-sectional study on drug dependence patients visiting the out patient clinic for addiction in Elmamora Hospital.

Subjects were divided into two groups.

Group I: Control group.

Twenty non-addict volunteers.

Group II: Cases groups (comprising 60 subjects)

This group will be divided into three sub-groups each contains 20 cases.

Group IIa: consuming tramadol.

Group IIb: consuming tramadol and heroin by injection.

Group IIc: consuming tramadol and heroin by inhalation.

All studied groups were subjected to:.

1. detailed history taking, urine screening tests for drugs of abuse, liver functions tests and HCV screening.

The study showed deterioration in liver function tests in the heroin and tramadol use groups compared to the tramadol only use.

There was a statistical significant difference in the incidence of HCV infection in the heroin injection group (85%) compared to 35% in the heroin non injector users and only 5% in tramadol users had HCV positive.

Heroin injection showed the highest risk for both liver function deterioration and HCV infection.

The authors have not supplied their declaration of competing interest.