Rapid transmission of hepatitis C virus among young injecting heroin users in Southern China
Rapid transmission of hepatitis C virus among young injecting heroin users in Southern China
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DOI：
10.1093/ije/dyh019
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发表时间：
2004-02-01
影响因子：
7.7
通讯作者：
Yu, XF
中科院分区：
文献类型：
--
作者：
Garten, RJ;Lai, SH;Yu, XF
背景丙型肝炎病毒（HCV）通过注射毒品迅速传播。HCV在中国海洛因使用者中的流行率和发病率很少报道。方法采用纵向队列研究方法，对597名中国南方青少年静脉吸毒者（IDU）血液传播感染的危险因素进行研究。对个体进行分析，以确定是否存在B型肝炎表面抗原和人类免疫缺陷病毒1型（HIV-1）、HCV和B型肝炎表面抗原抗体。使用自我报告的危险行为，进行多因素回归分析与HCV感染率和血清转换。结果在基线，HIV-1和HCV感染率分别为17%和72%。与HCV血清阳性率相关的重要因素包括年龄>25岁（比值比[OR] = 1.71）和注射吸毒>2年（OR = 2.60）。在开始使用海洛因的一年内，任何给药途径的HCV感染率均为57%，如果仅限于注射器，则为80%。两次6个月随访后，159例基线HCV血清阴性个体中有56例（148.9总人年[py]）发生血清转换，发生率为37.6/100 py。报告注射吸毒者更有可能发生HCV血清转化（比率[RR] = 6.59）。结论中国南方注射吸毒者中HCV感染迅速。这项研究强调，迫切需要在中国实施和扩大预防注射和初级药物滥用预防方案。
Background Hepatitis C virus (HCV) is quickly spread through injection drug use. The prevalence and incidence of HCV in Chinese heroin users has been rarely reported.Methods A longitudinal cohort of young injection drug users (IDU) from southern China was established to study the risk factors for blood-borne infections (597 subjects). Individuals underwent analysis for the presence of hepatitis B surface antigen and antibodies to human immunodeficiency virus type 1 (HIV-1), HCV and hepatitis B surface antigen. Using self-reported risk behaviours, multivariate regression analysis was performed for factors associated with HCV prevalence and seroconversion.Results At baseline, HIV-1 and HCV prevalence was 17% and 72%, respectively. Significant factors associated with HCV seroprevalence included age >25 years (odds ratio [OR] = 1.71) and injection drug use for >2 years (OR = 2.60). HCV prevalence within one year of starting heroin use was 57% for any route of administration, and 80% if restricted to injectors. After two 6-month follow-up visits, 56 out of 159 baseline HCV seronegative individuals (148.9 total person years [py]), underwent seroconversion at an incidence rate of 37.6 per 100 py. Individuals who reported injection drug use were more likely to undergo HCV seroconversion (rate ratio [RR] = 6.59).Conclusions HCV infection is rapidly acquired in heroin users who adopt injection in southern China. This study emphasizes the urgent need to implement and expand injection prevention and primary substance abuse prevention programmes in China.