Epidemiology of Hepatitis C Infection in the Household Population of Puerto Rico

关于丙型肝炎感染的流行病学的许多问题需要进一步调查。这些措施包括确定丙型肝炎在感染风险较大的人群中的流行率，因为注射吸毒导致艾滋病毒/艾滋病的高流行率；探索性行为在传播中的作用；以及评估其他潜在危险因素在感染中的作用。这项拟议的研究检查了丙型肝炎感染的血清阳性率，并评估性相关行为、其他危险行为和可能促进波多黎各18岁至岁家庭人口传播的混合感染模式。据我们所知，这是第一项以人群为基础的研究，以估计丙型肝炎感染的流行率，并调查拉美裔同种人群中感染的相关性。这项研究的发现有助于理解这种感染在中国的负担 并提供基线数据，以便与大陆其他拉美裔群体进行比较，最终将导致可能降低丙型肝炎病毒传播风险的干预措施。这项研究的具体目的是： 1.评估家庭、成人人群以及按年龄、性别和地理分层地区确定的特定人群丙型肝炎感染的血清阳性率 2.评估与性有关的具体做法在丙型肝炎感染、控制注射吸毒和社会人口学特征方面的作用 3.研究其他潜在危险因素(穿孔、纹身、非注射吸毒和共用毒品用具)在丙型肝炎感染中的作用，控制社会人口学特征 4.评估丙型肝炎与乙肝、艾滋病毒和单纯疱疹病毒混合感染的模式 5.评估高危行为(吸毒和与性有关的行为)与丙型肝炎与乙肝、艾滋病毒和单纯疱疹混合感染之间的关系 这项研究的设计基于全岛选择的2000名成年人的多阶段家庭概率样本。此前的调查显示，波多黎各吸毒者的危险行为水平高于美国本土的吸毒者。因此，预计该岛的丙型肝炎感染流行率会更高，注射吸毒、与性有关的做法和非注射来源造成的风险大小存在显著差异。

Many issues regarding the epidemiology of hepatitis C infection require further investigation. These include determining the prevalence of hepatitis C in populations that are at a greater risk for infection given the high prevalence of HIV/AIDS associated with injection drug use; exploring the role of sex-related practices in transmission; and assessing the role of other potential risk factors in infection. The proposed study examines seroprevalence of hepatitis C infection and assesses sex-related practices, other risk behaviors, and patterns of co-infections that might promote transmission among the household population aged 18 to 64 years in Puerto Rico. To our knowledge, this is the first population-based study to estimate the prevalence of hepatitis C infection and investigate correlates of infection in a homogeneous population of Hispanic origin. Findings from this study can contribute to understand the burden of this infection in a Hispanic population and provide baseline data for comparison purposes with other mainland Hispanic groups that will ultimately lead to interventions that may reduce the risk of transmission of hepatitis C virus. The specific aims of the study are: 1. To estimate the seroprevalence of hepatitis C infection for the household, adult population and for specific population groups defined by age, sex, and geographic stratification regions 2. To assess the role of specific sex-related practices in hepatitis C infection, controlling for injection drug use and socio-demographic characteristics 3. To examine the role of other potential risk factors (body piercing, tattooing, non-injecting drug use, and shared use of drug paraphernalia) in hepatitis C infection, controlling for socio-demographic characteristics 4. To assess the patterns of hepatitis C co-infections with hepatitis B, HIV and herpes simplex 5. To assess the relationships between high-risk behaviors (drug use practices and sex-related practices) and hepatitis C co-infections with hepatitis B, HIV and herpes simplex The study design is based on a multistage, household probability sample of 2,000 adults selected throughout the island. Previous investigations have shown that Puerto Rican drug users have higher levels of risk behaviors than their counterparts in the U.S. mainland. Therefore, a larger prevalence of hepatitis C infection is expected in the island, with marked variations in the magnitude of the risk attributable to injection drug use, sex-related practices, and non-injection sources.