Epidemiology and risk factors for hepatitis C virus infection in a high-prevalence population
Epidemiology and risk factors for hepatitis C virus infection in a high-prevalence population
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DOI：
10.1017/s0950268818000080
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发表时间：
2018-03-01
影响因子：
4.2
通讯作者：
Wester, C.
中科院分区：
文献类型：
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作者：
Fill, M. A.;Sizemore, L. A.;Wester, C.
为了了解田纳西州丙型肝炎病毒（HCV）感染率的增加，我们在吸毒者中进行了检测、危险因素分析和巢式病例对照研究。在2016年6月至10月期间，在田纳西州东部的性传播疾病诊所，计划生育诊所和成瘾治疗机构进行了HCV检测和风险因素评估;使用多变量logistic回归分析数据。进行了一项巢式病例对照研究，以评估报告鼻内或注射吸毒者的吸毒风险和行为。在4753名受检者中，397人（8.4%）HCV抗体阳性。HCV感染与鼻内和IDU病史（调整的比值比（aOR）35.4，95%置信区间（CI）24.1-51.9）、单独IDU（aOR 52.7，CI 25.3-109.9）、单独鼻内药物使用（aOR 2.6，CI 1.8-3.9）和嵌顿（aOR 2.7，CI 2.0-3.8）显著相关。截至2016年10月4日，有574人报告有吸毒史; 63人（11%）接受了进一步采访。在同时使用鼻内和注射药物的31人中，26人（84%）报告了既往鼻内药物使用，发生在首次IDU前1-18年（中位数5.5年）。我们的研究结果提供了证据表明，在研究人群中，报告的IDU，鼻内药物使用和监禁是过去或现在HCV感染风险的独立指标。
To understand increasing rates of hepatitis C virus (HCV) infection in Tennessee, we conducted testing, risk factor analysis and a nested case-control study among persons who use drugs. During June-October 2016, HCV testing with risk factor assessment was conducted in sexually transmitted disease clinics, family planning clinics and an addiction treatment facility in eastern Tennessee; data were analysed by using multivariable logistic regression. A nested case-control study was conducted to assess drug-using risks and behaviours among persons who reported intranasal or injection drug use (IDU). Of 4753 persons tested, 397 (8.4%) were HCV-antibody positive. HCV infection was significantly associated with a history of both intranasal and IDU (adjusted odds ratio (aOR) 35.4, 95% confidence interval (CI) 24.1-51.9), IDU alone (aOR 52.7, CI 25.3-109.9), intranasal drug use alone (aOR 2.6, CI 1.8-3.9) and incarceration (aOR 2.7, CI 2.0-3.8). By 4 October 2016, 574 persons with a reported history of drug use; 63 (11%) were interviewed further. Of 31 persons who used both intranasal and injection drugs, 26 (84%) reported previous intranasal drug use, occurring 1-18 years (median 5.5 years) before their first IDU. Our findings provide evidence that reported IDU, intranasal drug use and incarceration are independent indicators of risk for past or present HCV infection in the study population.