HCV TRANSMISSION: SEX, VIOLENCE ALCOHOL & DRUG USE

描述（改编自应用程序） 酗酒和吸毒者感染肝炎的人数不成比例 丙型肝炎病毒（HCV）。虽然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，精液的HCV感染性和 唾液是有争议的基于酒精和毒品的使用 与高风险性行为相关（例如，多个性伴侣，a 性传播疾病和肛交史），暴力行为，以及 意外伤害，我们假设：1）大量饮酒和其他药物使用 在性行为的背景下，通过血液与血液接触增加HCV传播 和其他亲密的互动，通过促进接触经血， 轻微和严重创伤引起的出血和2）大量饮酒可能 通过抑制免疫系统，增加血清HCV，促进HCV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， 和酒精/药物相关行为与可能的血液 16名性病门诊就诊者在性、亲密情况下的接触， 抗-HCV阳性400例，阴性1200例。HCV RNA的血清水平将 聚合酶链反应检测抗-HCV阳性者。关系 酒精/药物使用与HCV状态之间的关系以及 与高危性行为有关的血液接触， 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调查药物使用情况; 交互作用术语将用于研究性别和种族差异， 这些关系。聚类分析将用于识别行为 与HCV状态相关的类型学。最后，寿命的影响， 目前的饮酒模式对血清HCV RNA水平的影响将被调查， 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.