Modelling the force of infection for hepatitis B and hepatitis C in injecting drug users in England and Wales.
Modelling the force of infection for hepatitis B and hepatitis C in injecting drug users in England and Wales.
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DOI：
10.1186/1471-2334-6-93
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发表时间：
2006-06-08
影响因子：
3.7
通讯作者：
Hickman M
中科院分区：
文献类型：
--
作者：
Sutton AJ;Gay NJ;Edmunds WJ;Hope VD;Gill ON;Hickman M
注射吸毒是几种具有公共卫生重要性的感染的一个关键风险因素，特别是B型肝炎（HBV）和丙型肝炎（HCV）。在英格兰和威尔士，不到1%的人口可能是注射毒品使用者（IDUs），大约38%的HBV实验室报告和95%的HCV报告归因于注射毒品使用。在英格兰和威尔士各地与专门机构联系，对注射吸毒者进行了自愿的无联系匿名调查。自1990年以来，已对目前注射吸毒者的20，000多份唾液样本进行了HBV感染标志物检测，自1998年以来已纳入HCV检测。此处的分析考虑了1998-2003年接受HBV和HCV检测的注射吸毒者（n = 5，682）。本研究得出了注射吸毒人群中HBV和HCV感染力（易感注射吸毒者获得感染的比率）的最大似然估计值及其随时间和注射职业生涯长度的趋势。还考虑了个体风险行为异质性的存在以及由于注射以外的传播途径导致的背景HBV流行率。对于HBV和HCV，注射吸毒者在注射的第一年感染的风险最大（1999-2003年新同修的感染力：HBV = 0.1076 95% C.I：0.0840-0.1327 HCV = 0.1608 95% C.I：0.1314-0.1942）与有经验的注射吸毒者相比（1999-2003年有经验的注射吸毒者的感染力：HBV = 0.0353 95% C.I：0.0198-0.0596，HCV = 0.0526 95% C.I：0.0310-0.0863），尽管与此无关，有证据表明风险行为具有异质性，少数注射吸毒者感染风险增加。未检测到FOI随时间的变化趋势。只有有限的证据表明背景HBV感染是由于注射以外的因素造成的。这些模型强调需要增加针对新开始注射的干预措施，以减少血液传播病毒的传播。虽然从这里的证据来看，识别那些从事高风险行为的人也可能有助于规划有效的干预措施。这里所描述的数据和方法可以为监测公共卫生干预措施的成功提供一个基线。
Injecting drug use is a key risk factor, for several infections of public health importance, especially hepatitis B (HBV) and hepatitis C (HCV). In England and Wales, where less than 1% of the population are likely to be injecting drug users (IDUs), approximately 38% of laboratory reports of HBV, and 95% of HCV reports are attributed to injecting drug use. Voluntary unlinked anonymous surveys have been performed on IDUs in contact with specialist agencies throughout England and Wales. Since 1990 more than 20,000 saliva samples from current IDUs have been tested for markers of infection for HBV, HCV testing has been included since 1998. The analysis here considers those IDUs tested for HBV and HCV (n = 5,682) from 1998–2003. This study derives maximum likelihood estimates of the force of infection (the rate at which susceptible IDUs acquire infection) for HBV and HCV in the IDU population and their trends over time and injecting career length. The presence of individual heterogeneity of risk behaviour and background HBV prevalence due to routes of transmission other than injecting are also considered. For both HBV and HCV, IDUs are at greatest risk from infection in their first year of injecting (Forces of infection in new initiates 1999–2003: HBV = 0.1076 95% C.I: 0.0840–0.1327 HCV = 0.1608 95% C.I: 0.1314–0.1942) compared to experienced IDUs (Force of infection in experienced IDUs 1999–2003: HBV = 0.0353 95% C.I: 0.0198–0.0596, HCV = 0.0526 95% C.I: 0.0310–0.0863) although independently of this there is evidence of heterogeneity of risk behaviour with a small number of IDUs at increased risk of infection. No trends in the FOI over time were detected. There was only limited evidence of background HBV infection due to factors other than injecting. The models highlight the need to increase interventions that target new initiates to injecting to reduce the transmission of blood-borne viruses. Although from the evidence here, identification of those individuals that engage in heightened at-risk behaviour may also help in planning effective interventions. The data and methods described here may provide a baseline for monitoring the success of public health interventions.
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影响因子：
105.7
作者：
Judd, A;Hickman, M;Hall, AJ
通讯作者：
Hall, AJ
影响因子：
2
作者：
ADES, AE;MEDLEY, GF
通讯作者：
MEDLEY, GF
影响因子：
5
作者：
Hickman, M;Seaman, S;de Angelis, D
通讯作者：
de Angelis, D
影响因子：
12.7
作者：
Hope, VD;Judd, A;Gill, ON
通讯作者：
Gill, ON
影响因子：
4.4
作者：
Sutton, AJ;Gay, NJ;Gill, ON
通讯作者：
Gill, ON