HEPATITIS C IN IDUS--EPIDEMIOLOGY AND PREVENTION

描述：(申请人摘要) 注射用丙型肝炎病毒地方性感染问题 吸毒者(注射吸毒者)才刚刚开始被认识，尽管丙型肝炎病毒 注射吸毒者的感染率始终超过艾滋病毒或乙肝病毒的发病率。 到目前为止的研究还没有为发展紧急- 所需的丙型肝炎病毒预防计划。以贡献自己的长期目标为目标 将导致预防丙型肝炎病毒感染的干预措施的知识 在毒品注射器方面，本研究的具体目标如下： 目的1.描述静脉吸毒人群中丙型肝炎病毒感染的流行病学。我们会 测量400名丙型肝炎病毒血清阴性注射吸毒者中丙型肝炎病毒的发病率 三年期间，根据人口统计特征，注射 和性危险行为，以及参与减少伤害计划 例如针头交换和药物治疗。 目的2)研究丙型肝炎病毒传播的分子流行病学 IDU社交网络和2)注射吸毒者和其他患者群体之间的 社区。使用病例对照设计，我们将研究社会 血清转换为丙型肝炎病毒阳性的40-50名队列成员组成的网络(目标1) (索引主题)，并检查网络中与遗传相关的感染 成员与索引主题的风险行为相关。风险 网络成员将包括那些在性行为中使用毒品或发生性行为的人 在索引的时间段内与索引主体联系 获得性丙型肝炎病毒感染。分子病毒学方法将用于 将风险网络成员归类为相关菌株与不相关菌株。我们会 还研究了与扩散相关的社交网络的特征 丙型肝炎病毒在网络中的总感染率，如 网络，网络中存在多种基因类型，以及 网络中存在感染多种毒株的注射吸毒者。 此外，我们还将比较丙型肝炎病毒株之间的遗传距离。 在IDU受试者中与社区其他患者组中的受试者相同， 评估注射吸毒者与其他患者之间的传播程度。 这项研究的意义将在于它对我们的 了解丙型肝炎病毒的流行病学和危险因素可用于 制定适当的预防策略。这项研究也将增加 通过测量事件认识到丙型肝炎病毒问题的严重性 感染和调查注射吸毒者是否代表一个重要来源 丙型肝炎病毒传播到其他人群的可能性。

DESCRIPTION: (Applicant's Abstract) The problem of endemic hepatitis C virus (HCV) infection in injection drug users (IDUs) is only beginning to be recognized, although HCV infection rates in IDUs consistently exceed the incidence of HIV or HBV. Research to date has not provided the basis for development of urgently- needed HCV prevention programs. With the long-term goal of contributing to knowledge that will lead to interventions to prevent HCV infection in drug injectors, the specific aims of this study are the following: Aim 1. Describe the epidemiology of HCV infection in IDUs. We will measure HCV incidence in a cohort of 400 HCV-seronegative IDUs over a three year period, in relation to demographic characteristics, injection and sexual risk behaviors, and participation in harm reduction programs such as needle exchange and drug treatment. Aim 2. Study the molecular epidemiology of HCV transmission 1) within IDU social networks and 2) between IDUs and other patient groups in the community. Using a case-control design, we will study the social networks of 40-50 cohort members (Aim 1) who seroconvert to HCV-positive (index subjects), and examine genetically related infections in network members in relation to risk behavior with the index subject. Risk network members will include those who used drugs with or had sexual contact with the index subject during the time period when the index acquired HCV infection. Molecular virology methods will be used to classify risk network members as related vs. unrelated strains. We will also study characteristics of social networks associated with diffusion of HCV in the network, as indicated by overall HCV-prevalence in the network, the presence of multiple genotypes in the network, and the presence of IDUs in the network who are infected with multiple strains. Additionally, we will compare the genetic distance between HCV strains in IDU subjects to that in other patient groups in the community, to assess the degree of transmission between IDUs and other patients. The significance of this study will be its contribution to our understanding of HCV epidemiology and risk factors that may be used to develop appropriate prevention strategies. The study will also increase awareness of the magnitude of the problem of HCV by measuring incident infections and investigating whether IDUs represent an important source of HCV transmission to other segments of the population.