Syringe exchange and risk of infection with hepatitis B and C viruses
Syringe exchange and risk of infection with hepatitis B and C viruses
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DOI：
10.1093/oxfordjournals.aje.a009792
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发表时间：
1999-02-01
影响因子：
5
通讯作者：
Alexander, ER
中科院分区：
文献类型：
--
作者：
Hagan, H;McGough, JP;Alexander, ER
作者在西雅图注射吸毒者（IDUs）中进行了一项队列研究，以评估参与注射器交换计划是否与B型肝炎病毒（HBV）和丙型肝炎病毒（HCV）感染的发生率相关。从1994年6月至1996年1月，在药物治疗、矫正和社会服务机构中确定了敏感的IDU受试者（187例HCV抗体阴性，460例HBV核心抗体阴性），并在一年后进行了血清转换。分析中纳入的受试者为西雅图-金郡（华盛顿）地区的注射吸毒者，他们参加了一项大型多用途队列研究，即风险活动变量、流行病学和网络研究（RAVEN研究）。HCV感染39例（20.9/100/年），HBV感染46例（10.0/100/年）。注射器交换对HBV无明显保护作用（前交易所用户，相对风险（RR）= 0.68，95%置信区间（CI）0.2-2.5;零星交易所用户，RR = 2.4，95% CI 0.9-6.5;定期交易所用户，RR = 1.81，95% CI 0.7-4.8;而非交易所用户的RR = 1.0;调整为每日药物注射）。交换也不能预防HCV感染（零星使用者，RR = 2.6，95% CI 0.8-8.5;经常使用者，RR = 1.3，95% CI 0.8-2.2;与非使用者的RR = 1.0;调整最近开始注射和入组前共用注射器）。虽然不受控制的混杂或其他偏见可能掩盖了交换使用的真正有益影响，但这些数据表明，在研究期间没有发生这样的好处。
The authors utilized a cohort study among Seattle injection drug users (IDUs) to assess whether participation in a syringe exchange program was associated with incidence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. Susceptible IDU subjects (187 seronegative for antibody to HCV, and 460 seronegative for core antibody to HBV) were identified in drug treatment, corrections, and social service agencies from June 1994 to January 1996, and followed for seroconversion one year later. The subjects included in the analysis were Seattle-King County (Washington State) area IDUs enrolled in a larger multipurpose cohort study, the Risk Activity Variables, Epidemiology, and Network Study (RAVEN Study). There were 39 HCV infections (20.9/100/year) and 46 HBV infections (10.0/100/year). There was no apparent protective effect of syringe exchange against HBV (former exchange users, relative risk (RR) = 0.68, 95% confidence interval (CI) 0.2-2.5; sporadic exchange users, RR = 2.4, 95% CI 0.9-6.5; regular users, RR = 1.81, 95% CI 0.7-4.8; vs. RR = 1.0 for nonusers of the exchange; adjusted for daily drug injection). Neither did the exchange protect against HCV infection (sporadic users, RR = 2.6, 95% CI 0.8-8.5; regular users, RR = 1.3, 95% CI 0.8-2.2; vs. RR = 1.0 for nonusers; adjusted for recent onset of injection and syringe sharing prior to enrollment). While it is possible that uncontrolled confounding or other bias obscured a true beneficial impact of exchange use, these data suggest that no such benefit occurred during the period of the study.