Hepatitis C virus prevalence and estimated incidence among new injectors during the opioid epidemic in New York City, 2000-2017: Protective effects of non-injecting drug use
Hepatitis C virus prevalence and estimated incidence among new injectors during the opioid epidemic in New York City, 2000-2017: Protective effects of non-injecting drug use
复制标题
DOI：
10.1016/j.drugalcdep.2018.07.034
复制
发表时间：
2018-11-01
影响因子：
4.2
通讯作者：
Tross, Susan
中科院分区：
文献类型：
--
作者：
Des Jarlais, Don C.;Arasteh, K.;Tross, Susan
目的：评估纽约市 (NYC) 阿片类药物流行期间开始注射吸毒者中丙型肝炎病毒 (HCV) 的流行率和发病率，并确定减少注射吸毒者中 HCV 感染的可能新方向。方法：从参加西奈山贝斯以色列物质使用治疗计划的人员中招募了 846 名 2000 年至 2017 年间开始注射吸毒的人。进行了结构化访谈并进行了 HCV 抗体检测。在“逆转”到非注射吸毒者和除了注射外还使用非注射海洛因的人中，检查了非注射吸毒的保护作用。结果：参与者中有 79% 为男性，41% 为白人，15% 为非裔美国人，40% 为拉丁裔，平均年龄为 35 岁。在 2000 年或以后开始注射吸毒的人中，有 97 人（11%）“逆转”转变”回非注射毒品使用。反向转变与较低的 HCV 血清阳性率密切相关（继续注射者为 30%，而继续注射者为 47%，p < 0.005）。在继续注射的人中，HCV 血清阳性与当前非注射海洛因使用呈负相关（AOR = 0.72，95%CI 0.52-0.99）。继续注射者的 HCV 发病率 3 估计为 13/100 人年。目前注射可卡因的 HCV 血清阳性者特别有可能报告可能传播 HCV 的行为。结论：与美国其他地区类似，纽约市自 2000 年以来开始注射可卡因的人中 HCV 感染率很高。促进以非注射方式替代注射吸毒并减少 HCV 血清阳性者传播行为的新干预措施可能会为减少 HCV 传播提供其他方法。
Objective: Assess hepatitis C virus (HCV) prevalence and incidence among person who began injecting drugs during the opioid epidemic in New York City (NYC) and identify possible new directions for reducing HCV infection among persons who inject drugs.Methods: 846 persons who began injecting drugs between 2000 and 2017 were recruited from persons entering Mount Sinai Beth Israel substance use treatment programs. A structured interview was administered and HCV antibody testing conducted. Protective effects of non-injecting drug use were examined among persons who "reversed transitioned" to non-injecting drug use and persons who used non-injected heroin in addition to injecting.Results: Participants were 79% male, 41% White, 15% African-American, 40% Latinx, with a mean age of 35. Of those who began injecting in 2000 or later, 97 persons (11%) "reverse transitioned" back to non-injecting drug use. Reverse transitioning was strongly associated with lower HCV seroprevalence (30% versus 47% among those who continued injecting, p < 0.005). Among those who continued injecting, HCV seropositivity was inversely associated with current non-injecting heroin use (AOR = 0.72, 95%CI 0.52-0.99). HCV incidence 3 among persons continuing to inject was estimated as 13/100 person-years. HCV seropositive persons currently injecting cocaine were particularly likely to report behavior likely to transmit HCV.Conclusions: Similar to other locations in the US, NYC is experiencing high rates of HCV infection among persons who have begun injecting since 2000. New interventions that facilitate substitution of non-injecting for injecting drug use and that reduce transmission behavior among HCV seropositives may provide additional methods for reducing HCV transmission.