HEPATITIS C IN IDUS--EPIDEMIOLOGY AND PREVENTION

注射吸毒者丙型肝炎——流行病学和预防

• 批准号: 6362836
• 负责人: HANNE THIEDE
• 金额: $ 29.3万
• 依托单位: SEATTLE-KING COUNTY PUBLIC HEALTH DEPT
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-03-20 至 2003-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6362836
• 关键词: clinical research; disease /disorder prevention /control; disease /disorder proneness /risk; genetic strain; hepatitis C; hepatitis C virus; high risk behavior /lifestyle; human subject; intravenous drug abuse; longitudinal human study; needle sharing; nucleic acid sequence; small social group; substance abuse epidemiology

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.

描述：（申请人摘要） 注射地方性丙型肝炎病毒（HCV）感染问题 吸毒者 (IDU) 才刚刚开始被认识到，尽管 HCV 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。 迄今为止的研究尚未为紧急开发提供基础 需要 HCV 预防计划。 长期目标是做出贡献 获得可采取干预措施预防丙型肝炎病毒感染的知识 在注射吸毒者中，本研究的具体目的如下： 目标 1. 描述注射吸毒者中 HCV 感染的流行病学。 我们将 测量 400 名 HCV 血清阴性注射吸毒者超过 1 年的 HCV 发病率 三年期间，就人口特征而言，注射 和性风险行为，以及参与减少伤害计划 例如更换针头和药物治疗。 目标 2. 研究 HCV 传播的分子流行病学 1) IDU 社交网络以及 2) IDU 与其他患者群体之间 社区。我们将使用病例对照设计来研究社会 由 40-50 名血清转为 HCV 阳性的队列成员（目标 1）组成的网络 （索引科目），并检查网络中的遗传相关感染 成员与指数对象的风险行为有关。 风险 网络成员将包括那些吸毒或发生性行为的人 在指数发布期间与指数对象的接触 获得性 HCV 感染。 分子病毒学方法将用于 将风险网络成员分类为相关菌株和不相关菌株。 我们将 还研究与扩散相关的社交网络的特征 网络中 HCV 的数量，如网络中 HCV 总体流行率所示 网络，网络中存在多种基因型，以及 网络中存在感染多种毒株的注射吸毒者。 此外，我们将比较 HCV 毒株之间的遗传距离 在 IDU 受试者中与社区其他患者群体中的受试者相比， 评估注射吸毒者和其他患者之间的传播程度。 这项研究的意义在于它对我们的贡献 了解 HCV 流行病学和可用于预防的危险因素 制定适当的预防策略。 研究也会增加 通过测量事件来认识 HCV 问题的严重性 感染并调查注射吸毒者是否是一个重要来源 HCV 向其他人群传播的情况。