Risk factors for hepatitis C seropositivity among young people who inject drugs in New York City: Implications for prevention.
Risk factors for hepatitis C seropositivity among young people who inject drugs in New York City: Implications for prevention.
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DOI：
10.1371/journal.pone.0177341
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Edlin BR
中科院分区：
文献类型：
--
作者：
Eckhardt B;Winkelstein ER;Shu MA;Carden MR;McKnight C;Des Jarlais DC;Glesby MJ;Marks K;Edlin BR
丙型肝炎病毒（HCV）感染在美国仍然是一个严重的问题，注射毒品（PWID）的人不成比例地受到影响。在过去十年中，海洛因使用率增加了一倍多，青年人（18-25岁）的增幅最大。我们于2005年至2012年在纽约市对注射非法药物的年轻人进行了一项横断面研究，年龄为18至35岁或注射药物≤5年，以检查在注射器服务时代开始注射的年轻人中与HCV相关的潜在可改变因素。在714名参与者中，中位年龄为24岁;药物注射的中位持续时间为5年; 31%为女性; 75%被确定为白色; 69%报告无家可归; 48% [95%CI 44-52]有HCV抗体。与HCV相关的因素包括年龄较大（调整后的比值比[AOR]，1.99 [1.52-2.63]; p<0.001），注射药物使用时间较长（AOR，1.68 [1.39-2.02]; p<0.001），更频繁的注射（AOR，1.26 [1.09-1.45]; p = 0.001），使用使用过的注射器，个体数更多（AOR，1.26 [1.10-1.46]; p = 0.001），对保持未感染的信心较低（AOR，1.32 [1.07-1.63]; p<0.001），主要在公共场所或户外空间注射（AOR，1.90 [1.33-2.72]; p<0.001），携带注射器（AOR，3.17 [1.95-5.17]; p<0.001）。尽管提供了减少危害的服务，但2005-2012年期间，纽约市年轻PWID中的HCV血清阳性率仍然很高且恒定。年龄和几种注射行为赋予独立的风险。个人多少意识到了自己的风险。公共和户外注射以及因持有注射器而被捕是HCV的风险因素，可以通过结构性干预措施进行修改。
Hepatitis C virus (HCV) infection remains a significant problem in the United States, with people who inject drugs (PWID) disproportionately afflicted. Over the last decade rates of heroin use have more than doubled, with young persons (18–25 years) demonstrating the largest increase. We conducted a cross-sectional study in New York City from 2005 to 2012 among young people who injected illicit drugs, and were age 18 to 35 or had injected drugs for ≤5 years, to examine potentially modifiable factors associated with HCV among young adults who began injecting during the era of syringe services. Among 714 participants, the median age was 24 years; the median duration of drug injection was 5 years; 31% were women; 75% identified as white; 69% reported being homeless; and 48% [95% CI 44–52] had HCV antibodies. Factors associated with HCV included older age (adjusted odds ratio [AOR], 1.99 [1.52–2.63]; p<0.001), longer duration of injection drug use (AOR, 1.68 [1.39–2.02]; p<0.001),more frequent injection (AOR, 1.26 [1.09–1.45]; p = 0.001), using a used syringe with more individuals (AOR, 1.26 [1.10–1.46]; p = 0.001), less confidence in remaining uninfected (AOR, 1.32 [1.07–1.63]; p<0.001), injecting primarily in public or outdoors spaces (AOR, 1.90 [1.33–2.72]; p<0.001), and arrest for carrying syringes (AOR, 3.17 [1.95–5.17]; p<0.001). Despite the availability of harm reduction services, the seroprevalence of HCV in young PWID in New York City remained high and constant during 2005–2012. Age and several injection behaviors conferred independent risk. Individuals were somewhat aware of their own risk. Public and outdoor injection and arrest for possession of a syringe are risk factors for HCV that can be modified through structural interventions.