Susceptibility to Hepatitis A and B Virus Among Clients at a Syringe Services Program in Philadelphia, 2018
Susceptibility to Hepatitis A and B Virus Among Clients at a Syringe Services Program in Philadelphia, 2018
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DOI：
10.1177/0033354920943528
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发表时间：
2020-08-13
影响因子：
3.3
通讯作者：
Kuncio, Danica
中科院分区：
文献类型：
--
作者：
Figgatt, Mary;Hildick-Smith, Jack;Kuncio, Danica
目的虽然许多吸毒者符合接种甲型肝炎病毒（HAV）和B肝炎病毒（HBV）疫苗的标准，但对易感性（即缺乏免疫力）的估计还没有很好地建立。本研究旨在确定参加城市注射器服务项目的吸毒人群中HAV和HBV易感性的患病率和特征。我们于2018年在438名符合研究标准的注射器服务项目客户中启动了这项血清阳性率研究，包括提供血液标本和自我报告的吸毒史。我们通过血清学检测评估HAV和HBV易感性和感染。我们使用描述性统计和多变量逻辑回归模型研究了参与者特征和血清学状态之间的关系。结果在最初确定的438名客户中，353名（80.6%）符合研究标准。在352名具有确定性HAV检测结果的参与者中，48.6%（n = 171）为HAV易感者;在337名具有确定性HBV检测结果的参与者中，32.6%（n = 110）为HBV易感者，24.3%（n = 82）显示出既往或当前HBV感染的证据，43.0%（n = 145）具有疫苗衍生的免疫力。与1970年以前出生的参与者相比，1980-1989年出生的参与者有5.90（95%CI，2.42-14.40）是HAV易感性的几率的0.18倍，1990-1999年出生的受试者HBV易感性的几率是1990-1999年出生的受试者HAV易感性的几率的6.31倍（95%CI，0.06-0.53），1990-1999年出生的受试者HAV易感性的几率是1990 - 1999年出生的受试者HAV易感性的几率的6.31倍（95%CI，2.34-17.00）。HAV易感性降低的几率与无家可归相关（调整后的比值比= 0.48; 95%CI，0.28-0.82）。结论尽管有适用的HAV和HBV疫苗接种建议，但吸毒人群中HAV和HBV易感性存在巨大差距。这些发现强调了在吸毒者中增加HAV和HBV疫苗接种工作的必要性。
Objectives Although many people who use drugs meet criteria for vaccination against hepatitis A virus (HAV) and hepatitis B virus (HBV), estimates of susceptibility (ie, lack of immunity) are not well established. This study sought to identify the prevalence of and characteristics associated with HAV and HBV susceptibility among people who use drugs attending an urban syringe services program. Methods We initiated this seroprevalence study in 2018 among 438 clients of a syringe services program who met study criteria, including provision of a blood specimen and a self-reported history of drug use. We assessed HAV and HBV susceptibility and infection via serological testing. We examined associations between participant characteristics and serology status by using descriptive statistics and multivariable logistic regression models. Results Of the initial 438 clients identified, 353 (80.6%) met study criteria. Of 352 participants with conclusive HAV test results, 48.6% (n = 171) were HAV susceptible; of 337 participants with conclusive HBV test results, 32.6% (n = 110) were HBV susceptible, 24.3% (n = 82) showed evidence of past or present HBV infection, and 43.0% (n = 145) had vaccine-derived immunity. Compared with participants born before 1970, participants born during 1980-1989 had 5.90 (95% CI, 2.42-14.40) times the odds of HAV susceptibility and 0.18 (95% CI, 0.06-0.53) times the odds of HBV susceptibility, and participants born during 1990-1999 had 6.31 (95% CI, 2.34-17.00) times the odds of HAV susceptibility. Decreased odds of HAV susceptibility were associated with homelessness (adjusted odds ratio = 0.48; 95% CI, 0.28-0.82). Conclusion Despite applicable HAV and HBV vaccination recommendations, substantial gaps exist in HAV and HBV susceptibility among a population of people who use drugs. These findings highlight the need for increased HAV and HBV vaccination efforts among people who use drugs.