HCV TRANSMISSION: SEX, VIOLENCE ALCOHOL & DRUG USE

说明(改编自应用程序) 不成比例的酒精和毒品使用者感染肝炎 C病毒(丙型肝炎病毒)。尽管大多数新病例似乎是由于分享 受污染的毒品用具，约20%归因于性行为 与感染者接触。然而，精液和丙型肝炎病毒的传染性 唾液是有争议的。基于酒精和毒品的使用 与高危性行为有关(例如，多个性伴侣、 性传播疾病和肛交病史)、暴力行为和 意外伤害，我们假设：1)酗酒和其他药物使用 在性行为中通过血液接触增加丙型肝炎病毒的传播 和其他亲密互动，通过促进月经血和 轻微和重大创伤和2)大量饮酒引起的出血可能 通过抑制免疫系统、升高血清丙型肝炎病毒来促进丙型肝炎病毒的传播 RNA水平。 我们建议评估一生和目前的饮酒模式，其他药物使用情况， 以及与酒精/毒品相关的行为与可能的血液对血液有关 在16个性病诊所客户的性、亲密情况下进行接触， 抗-HCV阳性400例，阴性1200例。血清丙型肝炎病毒核糖核酸水平将是 聚合酶链式反应检测抗-丙型肝炎病毒阳性患者。两国关系 酒精/药物使用与丙型肝炎病毒状态之间的关系及其潜在的中介作用 与高危性行为有关的血液接触，性行为 受害、家庭暴力和其他暴力、意外伤害和不安全 使用分层回归分析技术对吸毒情况进行调查； 互动术语将用于调查性别和种族差异 这些关系。将使用聚类分析来识别行为 与丙型肝炎病毒状态相关的类型。最后，寿命和寿命的影响 将调查目前饮酒模式对血清丙型肝炎病毒RNA水平的影响 考虑到饮食、吸烟和伴随感染的影响。

DESCRIPTION (adapted from the application) Disproportionate numbers of alcohol and drug users are infected with Hepatitis C virus (HCV). Although the majority of new cases appear to result from sharing contaminated drug paraphernalia, approximately 20% are attributed to sexual contact with an infected person. However, the HCV infectivity of semen and saliva is controversial. Based on evidence that alcohol and drug use are associated with high-risk sexual behavior (e.g., multiple sexual partners, a history of sexually transmitted diseases, and anal sex), violent behavior, and accidental injuries, we postulate that: 1) heavy drinking and other drug use increase HCV transmission via blood-to-blood contact in the context of sexual and other intimate interactions by promoting exposure to menstrual blood and bleeding caused by minor and major trauma and 2) heavy alcohol consumption may promote HCV transmission by depressing the immune system, increasing serum HCV RNA levels. We propose to assess lifetime and current drinking patterns, other drug use, and alcohol/drug-related behavior associated with possible blood-to-blood contact in the context of sexual, intimate situations in 16 STD clinic clients, 400 positive for anti-HCV and 1200 negative. Serum levels of HCV RNA will be assessed in anti-HCV+ clients by polymerase chain reaction. The relations between-alcohol/drug use and HCV status and the potential mediating effects of blood-to-blood contact related to high-risk sexual behavior, sexual victimization, domestic and other violence, accidental injuries, and unsafe drug use will be investigated us hierarchical regression analytic techniques; interaction terms will be used to investigate gender and racial differences in these relations. Cluster analysis will be employed to identify behavioral typologies associated with HCV status. Finally, the influence of lifetime and current drinking patterns on serum HCV RNA levels will be investigated, taking into account the effects of diet, smoking, and concomitant infections.