Hepatitis C Virus Intranasal Transmission: Pilot Study

丙型肝炎病毒鼻内传播：试点研究

• 批准号: 7023858
• 负责人: James M McMahon
• 金额: $ 18.12万
• 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 2008-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7023858
• 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世界范围内的主要健康问题。丙型肝炎病毒（HCV）主要通过接触受感染的血液传播，已知的危险因素包括注射毒品、1992年以前接受血液或血液制品、纹身和身体穿孔以及医院接触。尽管人们对丙型肝炎病毒的传播了解很多，但相当大比例的感染者报告没有可确定的接触源。不明原因的丙型肝炎病毒病例在非注射吸毒者中特别高，这表明在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种假设是，丙型肝炎病毒可能通过鼻内吸毒者共用的吸管或勺子等受污染的嗅探/鼻吸工具传播。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，嗅探器可能会接触到感染丙型肝炎病毒的鼻分泌物或血液，然后可能传播给共用同一工具的未感染个体。虽然有几项研究表明鼻内用药是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传播方式相关的病毒学、临床和行为数据。拟议的试点研究将通过实现以下具体目标来帮助填补这些研究空白：(i)开发可靠的方法并进行实验室分析，以检测血浆阳性鼻内吸毒者鼻分泌物和吸药器具表面的HCV RNA；（ii）制定方法并进行分析，以检测鼻分泌物和嗅探器中是否存在血液；（iii）制定措施，收集初步数据，并评估一种工具的心理测量特性，以评估可能与鼻内HCV传播相关的风险因素；（iv）制定和评估慢性药物嗅探者的临床检查和鼻腔病理评估方案。虽然这些目标侧重于新技术的开发和未来研究的初步数据收集，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。