NATURAL HISTORY OF HCV INFECTION IN DRUG USERS

丙型肝炎病毒（HCV）感染是发病率和死亡率的主要原因。在美国所有高危人群中，注射吸毒者的HCV感染率最高。我们将前瞻性地研究美国所有高危人群中HCV感染的自然史。我们将前瞻性地研究HCV感染的自然史，在一个有HIV感染风险的吸毒者队列中。受试者将从已经参加了一项关于吸毒者艾滋病毒感染自然史的大型纵向研究的参与者中招募。因此，我们将能够利用在该研究中收集的大量复杂的数据集，并且我们将能够将收集的关于HCV感染自然史的新数据与这些数据联系起来。参与者将接受详细的标准化访谈，内容包括人口统计学、病史、性和药物使用行为、HIV和免疫检测，以及HCV感染检测，包括定量HCV RNA水平，包括定量HCV RNA水平、HCV基因分型、抗HCV抗体，以及部分参与者的HCV测序。发现有HCV感染的人将被转介给研究肝病学家进行肝脏疾病评估，并为他们的HCV感染提供标准的药物治疗。我们的目标是确定1)艾滋病毒感染及其相关的免疫缺陷的影响,HCV基因型,和吸毒行为HCV病毒载量和肝脏疾病的进展,2)艾滋病毒感染和免疫缺陷的影响反应治疗丙肝病毒感染,3)高活性抗逆转录病毒疗法的影响和控制HIV病毒载量的丙肝病毒感染的自然历史,和4)是否遗传多样性,推动了丙肝病毒的免疫缺陷。

Hepatitis C virus (HCV) infection is a major cause of morbidity and mortality. Injection drug users have the highest prevalence of HCV infection among all populations in the U.S. at risk. We will study prospectively the natural history of HCV infection among all populations in the U.S. at risk. We will study prospectively the natural history of HCV infection in a cohort of drug users with or at risk for HIV infection. Subjects will be recruited from among participants already enrolled in a large longitudinal study of the natural history of HIV infection in drug users. We will, therefore, be able to take advantage of the large and complex sets of data being collected in that study, and we will be able to link new data that will be collecting on the natural history of HCV infection with those data. Participants will have detailed standardized interviews on demographics, medical history, sexual and drug use behaviors, HIV and immunological testing, and testing for HCV infection, including quantitative HCV RNA levels, including quantitative HCV RNA levels, HCV genotyping, anti-HCV antibodies and, in a subset of participants, HCV sequencing. Persons found to have HCV infection will be referred to the study hepatologist to be evaluated for liver disease and they will be offered standard medical therapy for their HCV infection. Our aims are to determine 1) the effects of HIV infection and its associated immunodeficiency, HCV genotype, and drug use behaviors on HCV viral load and progression of liver disease, 2) the effects of HIV infection and immunodeficiency on response to therapy for HCV infection, 3) the effects of highly active anti-retroviral therapy and control of HIV viral load on the natural history of HCV infection, and 4) whether genetic diversity of HCV is facilitated by immunodeficiency.