Economic recession and emergence of an HIV-1 outbreak among drug injectors in Athens metropolitan area: a longitudinal study.
Economic recession and emergence of an HIV-1 outbreak among drug injectors in Athens metropolitan area: a longitudinal study.
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DOI：
10.1371/journal.pone.0078941
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Hatzakis A
中科院分区：
文献类型：
--
作者：
Paraskevis D;Nikolopoulos G;Fotiou A;Tsiara C;Paraskeva D;Sypsa V;Lazanas M;Gargalianos P;Psichogiou M;Skoutelis A;Wiessing L;Friedman SR;Jarlais DC;Terzidou M;Kremastinou J;Malliori M;Hatzakis A
2011年期间，在希腊雅典，注射吸毒者中报告的艾滋病毒-1感染急剧增加（1600%）。我们在此评估了与此次疫情相关的潜在因果途径。我们的研究采用了高分辨率的HIV-1系统发育和地理分布分析。我们还研究了生态变量的纵向数据，如希腊国内生产总值（GDP）的年增长与注射吸毒者中HIV-1和HCV哨点流行率，失业率和无家可归率以及经济衰退之前和期间（2008-2012年）雅典注射吸毒者的HIV传播网络。2011年和2012年采样的IDU分离株表明，94.6%和92.7%的病例存在传播网络，与1998-2009年期间的零星网络（5%）形成鲜明对比。大多数HIV-1分离株的地理来源与最近记录的希腊移民潮一致。国内生产总值的下降与艾滋病毒和丙型肝炎病毒的年流行率以及注射吸毒者的失业率和无家可归率呈负相关（均为p<0.001）。与2002-2006年相比，2008-2012年（经济衰退）注射吸毒者和“新”药物注射者哨点人群中抗-HCV流行率的斜率分别高出120倍和1.9倍（p = 0.007，p =0.08）。 在2008-2012年和1998-2007年，传播网络的中位数（第25位，第75位）分别为34（12，58）和2（2，2）（p =0.057）。 在整个研究期间，减少危害服务的覆盖率很低。在可能爆发艾滋病毒-1的环境中，应紧急考虑扩大减少危害服务，解决与当前经济危机有关的社会和结构性因素。
During 2011, a dramatic increase (1600%) of reported HIV-1 infections among injecting drug users (IDUs) was noted in Athens, Greece. We herein assess the potential causal pathways associated with this outbreak. Our study employed high resolution HIV-1 phylogenetic and phylogeographic analyses. We examined also longitudinal data of ecological variables such as the annual growth of gross domestic product (GDP) of Greece in association with HIV-1 and HCV sentinel prevalence in IDUs, unemployment and homelessness rates and HIV transmission networks in Athens IDUs before and during economic recession (2008–2012). IDU isolates sampled in 2011 and 2012 suggested transmission networks in 94.6% and 92.7% of the cases in striking contrast with the sporadic networking (5%) during 1998–2009. The geographic origin of most HIV-1 isolates was consistent with the recently documented migratory waves in Greece. The decline in GDP was inversely correlated with annual prevalence rates of HIV and HCV and with unemployment and homelessness rates in IDUs (all p<0.001). The slope of anti-HCV prevalence in the sentinel populations of IDUs and in “new” drug injectors was found 120 and 1.9-fold (p = 0.007, p = 0.08 respectively) higher in 2008–2012 (economic recession) compared with 2002–2006. The median (25th, 75th) size of transmission networks were 34 (12, 58) and 2 (2, 2) (p = 0.057) in 2008–2012 and 1998–2007, respectively. The coverage of harm reduction services was low throughout the study period. Scaling-up harm reduction services and addressing social and structural factors related to the current economic crisis should be urgently considered in environments where HIV-1 outbreaks may occur.
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影响因子：
168.9
作者：
Mathers, Bradley M.;Degenhardt, Louisa;Mattick, Richard P.
通讯作者：
Mattick, Richard P.
影响因子：
4.4
作者：
Tempalski, Barbara;Cooper, Hannah L.;Gostnell, Karla
通讯作者：
Gostnell, Karla
DOI：
10.1016/s0140-6736(10)60743-x
发表时间：
2010-07-24
期刊：
Lancet (London, England)
影响因子：
--
作者：
Strathdee SA;Hallett TB;Bobrova N;Rhodes T;Booth R;Abdool R;Hankins CA
通讯作者：
Hankins CA
影响因子：
3.1
作者：
Nikolopoulos, G.;Paraskevis, D.;Hatzakis, A.
通讯作者：
Hatzakis, A.
影响因子：
168.9
作者：
Mathers, Bradley M.;Degenhardt, Louisa;Strathdee, Steffanie A.
通讯作者：
Strathdee, Steffanie A.