Characterization of the Emerging HIV Type 1 and HCV Epidemics among Injecting Drug Users in Dushanbe, Tajikistan
Characterization of the Emerging HIV Type 1 and HCV Epidemics among Injecting Drug Users in Dushanbe, Tajikistan
复制标题
DOI：
10.1089/aid.2008.0206
复制
发表时间：
2009-09-01
影响因子：
1.5
通讯作者：
Strathdee, Steffanie A.
中科院分区：
文献类型：
--
作者：
Beyrer, Chris;Patel, Zeenat;Strathdee, Steffanie A.
本研究旨在确定塔吉克斯坦杜尚别注射吸毒者中艾滋病毒、丙型肝炎病毒和梅毒的流行率及其相关性，并描述HIV-1的分子流行病学特征。一项通过访谈管理的调查评估艾滋病毒和丙型肝炎病毒风险因素的横断面研究进行了。2004年5月至11月，塔吉克斯坦杜尚别共招募了491名现役成人注射吸毒者。用快速检测方法检测HIV-1抗体状态，并用酶联免疫吸附试验进行确认。丙型肝炎病毒抗体检测使用BIOELISA丙型肝炎病毒试剂盒。对HIV-1亚型进行全长测序。用Logistic回归分析HIV和丙型肝炎病毒感染的相关性。HIV总感染率为12.1%，丙型肝炎病毒感染率为61.3%，梅毒感染率为15.7%。在控制性别和种族的多因素Logistic回归模型中，每天注射毒品[优势比(OR)3.22]和塔吉克国籍(OR 7.06)与HIV感染显著相关。塔吉克族(OR 1.91)、逮捕史(OR 2.37)、过去10年在塔吉克斯坦境外生活/工作(OR 2.43)和每天注射毒品(OR 3.26)与丙型肝炎病毒感染显著相关，而女性(OR 0.53)和经常使用无菌针头(OR 0.47)与丙型肝炎病毒感染呈负相关。在20例HIV-1阳性IDU中，10例为A亚型，9例为CRF02_AG亚型，1例为A-CRF02_AG重组型。杜尚别正在流行艾滋病毒-1、丙型肝炎病毒和吸毒。分子流行病学是独特的，西非变异约占流行感染的50%。迫切需要提供针头交换计划和鸦片替代疗法的有针对性的预防计划，以防止艾滋病毒和丙型肝炎病毒在塔吉克斯坦的进一步传播。
This study aimed to determine HIV, HCV, and syphilis prevalence and correlates, and to characterize the molecular epidemiology of HIV-1 among injecting drug users (IDUs) in Dushanbe, Tajikistan. A cross-sectional study assessing risk factors for HIV and HCV through an interview administered survey was conducted. A total of 491 active adult IDUs were recruited from May to November 2004 in Dushanbe, Tajikistan. HIV-1 antibody status was determined with rapid testing and confirmed with ELISA. HCV antibody testing was conducted using a BIOELISA HCV kit. HIV-1 subtyping was done on a subset with full-length sequencing. Correlates of HIV and HCV infection were assessed using logistic regression. Overall prevalence of HIV was 12.1%, HCV was 61.3%, and syphilis was 15.7%. In a multivariate logistic regression model controlling for gender and ethnicity, daily injection of narcotics [odds ratio (OR) OR 3.22] and Tajik nationality (OR 7.06) were significantly associated with HIV status. Tajik nationality (OR 1.91), history of arrest (OR 2.37), living/working outside Tajikistan in the past 10 years (OR 2.43), and daily injection of narcotics (OR 3.26) were significantly associated with HCV infection whereas being female (OR 0.53) and always using a sterile needle (OR 0.47) were inversely associated with HCV infection. Among 20 HIV-1-positive IDU with specimens available for typing, 10 were subtype A, 9 were CRF02_AG, and one was an A-CRF02_AG recombinant. Epidemics of HIV-1, HCV, and drug use are underway in Dushanbe. The molecular epidemiology is distinctive, with West African variants accounting for roughly 50% of prevalent infections. Targeted prevention programs offering both needle exchange programs and opiate substitution therapies are urgently called for to prevent the further spread of HIV and HCV in Tajikistan.