A vulnerability assessment for the HCV infections associated with injection drug use.
A vulnerability assessment for the HCV infections associated with injection drug use.
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DOI：
10.1016/j.ypmed.2020.106040
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发表时间：
2020-02
影响因子：
5.1
通讯作者：
Nasser Sharareh;R. Hess;Scott White;Angela C. Dunn;Phillip M. Singer;J. Cochran
中科院分区：
文献类型：
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作者：
Nasser Sharareh;R. Hess;Scott White;Angela C. Dunn;Phillip M. Singer;J. Cochran
印第安纳州斯科特县2014-2015年艾滋病毒暴发后，美国疾病控制和预防中心(CDC)在全国范围内进行了分析，以确定易受丙型肝炎病毒(丙型肝炎病毒)/人类免疫缺陷病毒(HIV)疫情影响的县，并防止未来发生此类疫情。我们开发了犹他州与注射吸毒(IDU)相关的丙型肝炎病毒感染的司法管辖级脆弱性评估。我们使用来自15个数据源的三年数据(2015-2017)来构建回归模型，以确定IDU的重要指标。不存在IDU的邮政编码、县或个人级别的衡量标准，因此，CDC建议使用丙型肝炎病例作为IDU的替代。我们使用社会脆弱性指数来突出易受丙型肝炎疫情影响的地区，并应用地理信息系统(GIS)来确定丙型肝炎病毒感染的热点(即当前/正在进行的丙型肝炎病毒传播)。皮肤感染率、丁丙诺啡处方、使用纳洛酮、青少年出生和人均收入与丙型肝炎病毒感染相关。阿片类药物流行是动态的，随着时间的推移，它通过其后遗症，如丙型肝炎病毒爆发，影响不同的社区。我们需要经常使用更新的数据进行这种脆弱性评估，以便更好地针对我们的资源。此外，我们应该考虑评估丙型肝炎筛查的改进是否对控制丙型肝炎暴发有影响。这项分析为犹他州的机构和卫生保健官员提供了有针对性的资源和干预措施，以防止IDU相关的丙型肝炎病毒暴发。我们的结果也向国家一级的政策制定者通报了可能的丙型肝炎暴发指标。
After the 2014–2015 HIV outbreak in Scott County, Indiana, United States Centers for Disease Control and Prevention (CDC) conducted a nationwide analysis to identify vulnerable counties to an outbreak of Hepatitis C Virus (HCV)/Human Immunodeficiency Virus (HIV) and prevent such an outbreak in the future. We developed a jurisdiction-level vulnerability assessment for HCV infections associated with injection drug use (IDU) in Utah.We used three years of data (2015–2017) from 15 data sources to construct a regression model to identify significant indicators of IDU. A ZIP Code, county, or individual-level measure of IDU does not exist, therefore, CDC has suggested using HCV cases as a proxy for IDU. We used the Social Vulnerability Index to highlight vulnerable areas to HCV outbreaks and applied Geographical Information System (GIS) to identify hot spots of HCV infections (i.e. current/ongoing HCV transmissions). Rates of skin infection, buprenorphine prescription, administered naloxone, teen birth, and per capita income were associated with HCV infections.The opioid epidemic is dynamic and over time, it impacts different communities through its sequelae such as HCV outbreaks. We need to conduct this vulnerability assessment frequently, using updated data, to better target our resources. Moreover, we should consider evaluating whether the improvement of HCV screening has an impact on controlling HCV outbreaks. The analysis informs Utah's agencies and healthcare officials to target resources and interventions to prevent IDU-related HCV outbreaks. Our results inform policymakers at the national level on possible indicators of HCV outbreaks as well.