Is the HCV-HIV co-infection prevalence amongst injecting drug users a marker for the level of sexual and injection related HIV transmission?
Is the HCV-HIV co-infection prevalence amongst injecting drug users a marker for the level of sexual and injection related HIV transmission?
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DOI：
10.1016/j.drugalcdep.2013.01.020
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发表时间：
2013-09-01
影响因子：
4.2
通讯作者：
Hickman, Matthew
中科院分区：
文献类型：
--
作者：
Vickerman, Peter;Martin, Natasha K.;Hickman, Matthew
背景：在注射毒品使用者（IDUs）中，HIV通过性和非肠道途径传播，但HCV主要通过非肠道途径传播。我们评估和模型之间的HIV感染的注射吸毒者（表示为HCV-HIV合并感染的患病率），并考虑它是否代理的程度之间的性HIV传播IDUs.Methods：HIV，HCV和HCV-HIV合并感染的患病率数据之间的注射吸毒者进行了审查。采用了HIV/HCV传播模型。多变量模型不确定性分析确定模型复制观察到的数据趋势的能力是否需要纳入性传播艾滋病毒。模型的HCV-HIV合并感染的患病率和估计的HIV感染的比例，由于injecting.Results之间的相关性进行了评估：中位HCV-HIV合并感染的患病率（HCV感染的注射吸毒者之间的患病率）为90%，从43个国家的195个估计。在大多数（75%）环境中，HCV-HIV合并感染患病率较高（>80%），但在HIV患病率较低的环境中可能较低（0.75）。没有性传播的模型再现了一些数据趋势，但不能再现任何高HIV/HCV流行率（>0.85）或低HCV-HIV合并感染流行率（10%）的流行。艾滋病毒性传播的模型更接近地再现了数据趋势。结论：注射吸毒人群中可能存在大量的HIV性传播，HCV/HIV合并感染的发生率较高。(C)2013爱思唯尔爱尔兰有限公司保留所有权利。
Background: Amongst injecting drug users (IDUs), HIV is transmitted sexually and parenterally, but HCV is transmitted primarily parenterally. We assess and model the antibody prevalence of HCV amongst HIV-infected IDUs (denoted as HCV-HIV co-infection prevalence) and consider whether it proxies the degree of sexual HIV transmission amongst IDUs.Methods: HIV, HCV and HCV-HIV co-infection prevalence data amongst IDU was reviewed. An HIV/HCV transmission model was adapted. Multivariate model uncertainty analyses determined whether the model's ability to replicate observed data trends required the inclusion of sexual HIV transmission. The correlation between the model's HCV-HIV co-infection prevalence and estimated proportion of HIV infections due to injecting was evaluated.Results: The median HCV-HIV co-infection prevalence (prevalence of HCV amongst HIV-infected IDUs) was 90% across 195 estimates from 43 countries. High HCV-HIV co-infection prevalences (>80%) occur in most (75%) settings, but can be lower in settings with low HIV prevalence (0.75). The model without sexual HIV transmission reproduced some data trends but could not reproduce any epidemics with high HIV/HCV prevalence ratios (>0.85) or low HCV-HIV co-infection prevalence ( 10%. The model with sexual HIV transmission reproduced data trends more closely. The proportion of HIV infections due to injecting correlated with HCV-HIV co-infection prevalence; suggesting that up to 80/60/90%.Conclusion: Substantial sexual HIV transmission may occur in many IDU populations; HCV-HIV coinfection prevalence could signify its importance. (C) 2013 Elsevier Ireland Ltd. All rights reserved.