Etiology and Prevention of Blood borne Viruses in IDUs

描述（由申请人提供）：血源性 注射毒品使用者（IDUs）的病毒感染尚未得到充分 特征，并且关于哪些注射实践仍然存在许多问题 可能导致感染。注射吸毒者中的病毒性肝炎感染属于 最常发生的81 ood-bornel l感染在人类;在低 注射吸毒者艾滋病毒流行情况、发病率和死亡率 肝炎病毒感染可能超过艾滋病毒。丙型肝炎病毒（HCV）是 在IDU人群中高度流行，并且更有效地传播， 比注射艾滋病病毒更有效。由于HCV的性传播相对罕见， 它可以作为一种高度敏感的生物标记物， 暴露于这些感染的药物注射器，并可能有助于 了解通过注射传播其他感染的机制 实践我们研究的长期目标是增进对 流行病学、病因学和预防注射吸毒者中的艾滋病毒和肝炎感染。 我们提出的研究将为我们的长期目标做出新的贡献： 目标1。检查西雅图的HCV预防教育的程度 针头交换计划降低了HCV感染的风险。目标二。测量 与特定注射风险相关的HCV血清转换风险 行为，并计算可归因于这些行为的HCV风险， 注射吸毒人口。目标3：比较报告社会不受欢迎或污名化 A-CASI收集的注射和性风险行为， 访谈者管理的数据收集方法。目标4。评估的可行性 以及HBV和HCV伴侣通知对注射吸毒者的疾病控制益处。目的 5.研究丙型肝炎报告法律的变化是否与 注射吸毒者的报告增加。这项研究的意义在于它的潜力 有助于我们了解这些感染的病因， 研究了许多与公共卫生有效性有关的实际问题 监测和预防方案。

DESCRIPTION (provided by applicant): The etiology and prevention of blood-borne viral infections in injection drug users (IDUs) have not been fully characterized, and many questions remain regarding which injection practices may result in I infection. Viral hepatitis infections in IDUs are among the most frequently occurring 81ood-bornel l infections in humans; in low HIV-prevalence settings, morbidity and mortality in IDUs attributable to l hepatitis virus infections may exceed that for HIV. Hepatitis C virus (HCV) is highly prevalent in IDU- populations, and is more efficiently transmitted l abouty injection than HIV. Because sexual HCV transmission is relatively rare, it may serve as a highly sensitive biologic marker of direct percutaneous exposure to these infections in drug injectors, and may contribute to understanding the mechanism of transmission of other infections via injection practices. The long-term goal of our research is to advance knowledge of the epidemiology, etiology and-prevention of HIV and hepatitis infections in IDUs. We propose studies that will make new contributions toward our long-term goal: Aim 1. Examine the extent to which HCV prevention education at the Seattle needle exchange program has reduced the risk of HCV infection. Aim 2. Measure the risk of HCV seroconversion associated with specific injection risk behaviors, and calculate the risk of HCV attributable to these practices in the IDU-population. Aim 3. Compare reporting of socially-undesirable or stigmatized injection and sexual risk behavior collected by A-CASI to interviewer-administered data collection methods. Aim 4. Assess the feasibility and disease control benefits of HBV and HCV partner notification for IDUs. Aim 5. Study whether changes in hepatitis C reporting laws are associated with increased reporting in IDUs. The significance of this research is its potential contribution to our understanding of the etiology of these l infections, and examines many practical questions related to the effectiveness of public health surveillance and prevention programs.