Implications of hepatitis C viremia vs. antibody alone on transmission among male injecting drug users in three Afghan cities.
Implications of hepatitis C viremia vs. antibody alone on transmission among male injecting drug users in three Afghan cities.
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丙型肝炎病毒血症与单独抗体对阿富汗三个城市男性注射吸毒者传播的影响。
DOI：
10.1016/j.ijid.2010.11.006
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发表时间：
2011
期刊：
影响因子：
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通讯作者：
Tjaden,Jeffrey
中科院分区：
文献类型：
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作者：
Nasir,Abdul;Todd,CatherineS;Stanekzai,MohammadR;Bautista,ChristianT;Botros,BoulosA;Scott,PaulT;Kim,JeromeH;Strathdee,SteffanieA;Tjaden,Jeffrey
目的评估阿富汗三个城市中患有丙型肝炎病毒（HCV）病毒血症的注射吸毒者（IDUs）与患有HCV抗体（Ab）或无既往感染证据的注射吸毒者（IDUs）之间的差异。方法赫拉特、贾拉拉巴德和马扎里沙里夫的注射吸毒者完成了调查问卷和血液传播感染（包括HCV Ab）的快速检测。用重组免疫印迹法（RIBA）确认HCV抗体;对RIBA阳性标本进行HCV逆转录聚合酶链反应（RT-PCR）。与病毒血症相关的危险行为采用现场控制的有序回归分析进行评估。在609名参与者中，223名（36.6%）确认了HCV抗体。在221例可用于PCR评价的血清中，127例（57.5%）为病毒血症。不同研究中心的HCV病毒血症患病率无差异（范围41.7-59.1%; p=0.52）。在所有注射吸毒者中，在年龄和地点控制的顺序回归分析中，HCV与HIV合并感染独立相关（调整的比值比（AOR）7.16，95%置信区间（CI）4.41-11.64），既往成瘾治疗（AOR 1.95，95% CI 1.57-2.42），曾经抽吸和再注射血液（AOR 1.62，95% CI 1.18-2.23），既往监禁（AOR 1.60，95% CI 1.04-2.45），在过去6个月内共用注射设备（AOR 1.35，95%CI 1.02-1.80）。结论HCV病毒血症存在于许多既往HCV感染的受试者中，并与某些注射危险行为有关，表明有很大的传播风险目前的减少危害方案应将提高阿富汗注射吸毒者对HCV的认识和预防作为当务之急。
OBJECTIVESTo assess differences between injecting drug users (IDUs) with hepatitis C virus (HCV) viremia and IDUs with HCV antibody (Ab) or no evidence of prior infection in three Afghan cities.METHODSIDUs in Hirat, Jalalabad, and Mazar-i-Sharif completed questionnaires and rapid testing for blood-borne infections including HCV Ab. HCV Ab was confirmed with a recombinant immunoblot assay (RIBA); RIBA-positive specimens underwent reverse transcriptase polymerase chain reaction (RT-PCR) for HCV. Risk behaviors associated with viremia were assessed with site-controlled ordinal regression analysis.RESULTSOf 609 participants, 223 (36.6%) had confirmed HCV Ab. Of 221 with serum available for PCR evaluation, 127 (57.5%) were viremic. HCV viremia prevalence did not differ by site (range 41.7–59.1%; p=0.52). Among all IDUs, in age and site-controlled ordinal regression analysis, HCV was independently associated with HIV co-infection (adjusted odds ratio (AOR) 7.16, 95% confidence interval (CI) 4.41–11.64), prior addiction treatment (AOR 1.95, 95% CI 1.57–2.42), ever aspirating and re-injecting blood (AOR 1.62, 95% CI 1.18–2.23), prior incarceration (AOR 1.60, 95% CI 1.04–2.45), and sharing injecting equipment in the last 6 months (AOR 1.35, 95% CI 1.02–1.80).CONCLUSIONHCV viremia was present in many participants with prior HCV infection and was associated with some injecting risk behaviors, indicating a substantial risk for transmission. Current harm reduction programs should aim to improve HCV awareness and prevention among IDUs in Afghanistan as a matter of urgency.