Hepatitis C Virus Intranasal Transmission: Pilot Study

丙型肝炎病毒鼻内传播：试点研究

• 批准号: 6947597
• 负责人: James M McMahon
• 金额: $ 15.92万
• 依托单位: NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-04-01 至 2007-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6947597
• 关键词: blood; chronic disease /disorder; clinical research; communicable disease transmission; data collection; disease /disorder proneness /risk; hepatitis C; hepatitis C virus; human subject; inhalation drug abuse; method development; pathology; patient oriented research; psychometrics; questionnaires; respiratory disorder diagnosis; virus RNA

Chronic active hepatitis C is a major health concern in the United States and worldwide. Hepatitis C virus (HCV) is primarily transmitted through contact with infected blood, with known risk factors including injection drug use, receipt of blood or blood products prior to 1992, tattoo and body piercing, and nosocomial exposure. Although much is known about HCV transmission, a substantial proportion of infected individuals report no identifiable source of exposure. Unexplained cases of HCV are particularly high among noninjection drug users, indicating a potential hidden source of infection within this group. One hypothesis to account for these unexplained cases is that HCV may be transmitted through contaminated sniffing/snorting implements, such as straws or spoons, shared by intranasal drug users. Snorted cocaine and other powdered drugs can irritate the nasal membranes causing deterioration, leakage and bleeding. When inserted into the nasal cavity, a sniffing implement may come into contact with HCV-infected nasal secretions or blood, which may then be transmitted to an uninfected individual sharing the same implement. Although several studies have shown intranasal drug use to be a significant risk factor for HCV infection, there is nearly a complete absence of virological, clinical, and behavioral data pertaining to this potential mode of HCV transmission. The proposed pilot study will help fill these research gaps by achieving the following specific aims: (i) develop reliable methods and perform laboratory assays to detect HCV RNA in the nasal secretions of plasma-positive intranasal drug users and on the surfaces of drug-sniffing implements; (ii) develop methods and perform assays to test for the presence of blood in nasal secretions and sniffing-implements, (iii) develop measures, collect preliminary data, and evaluate the psychometric properties of an instrument to assess risk factors that may be associate with intranasal HCV transmission; and (iv) develop and evaluate protocols for clinical examination and assessment of nasal cavity pathology among chronic drug-sniffers. While these aims focus on the development of new technologies and the collection of preliminary data for future research, the proposed study will, nonetheless, resolve several fundamental questions regarding the preconditions necessary for intranasal HCV transmission.

慢性活动性丙型肝炎是美国和全世界的主要健康问题。丙型肝炎病毒（HCV）主要通过接触受感染的血液传播，已知的风险因素包括注射吸毒，1992年之前接受血液或血液制品，纹身和身体穿孔以及医院接触。虽然对HCV传播了解很多，但相当一部分感染者报告没有可识别的暴露源。原因不明的HCV病例在非注射吸毒者中特别高，表明这一群体中存在潜在的隐藏感染源。解释这些无法解释的病例的一个假设是，HCV可能通过鼻内吸毒者共用的受污染的嗅/吸工具（如吸管或勺子）传播。吸食可卡因和其他粉末状药物会刺激鼻膜，导致恶化、渗漏和出血。当插入鼻腔时，嗅探器具可能与HCV感染的鼻腔分泌物或血液接触，然后可能传播给共用同一器具的未感染个体。虽然一些研究表明鼻内药物使用是HCV感染的一个重要危险因素，但几乎完全缺乏与这种潜在的HCV传播模式有关的病毒学，临床和行为学数据。拟议的试点研究将有助于填补这些研究空白，实现以下具体目标：（i）开发可靠的方法，并进行实验室检测，以检测血浆阳性鼻内吸毒者的鼻腔分泌物和毒品嗅探工具表面上的HCV RNA;（ii）制订方法和进行化验，以测试鼻腔分泌物和嗅闻器具中是否有血液，（iii）制订措施，收集初步的数据，并评估心理测量学性质的仪器，以评估可能与鼻内丙型肝炎病毒传播的危险因素;和（iv）制定和评估方案的临床检查和慢性药物嗅探者鼻腔病理评估。虽然这些目标的重点是新技术的开发和为未来研究收集初步数据，但拟议的研究将解决有关鼻内HCV传播所需先决条件的几个基本问题。