HEPATITIS C IN IDUS--EPIDEMIOLOGY AND PREVENTION

描述：（申请人摘要） 注射用地方性丙型肝炎病毒感染问题 吸毒者（IDUs）才刚刚开始被认识，尽管HCV 注射吸毒者的感染率始终超过艾滋病毒或乙型肝炎病毒的发病率。 到目前为止，研究还没有为紧急开发提供基础- 需要HCV预防计划。 长期的目标是为 了解将导致预防HCV感染的干预措施的知识 在药物注射器中，本研究的具体目的如下： 目标1. 描述注射吸毒者中HCV感染的流行病学。 我们将 在400名HCV血清阴性的静脉吸毒者队列中， 三年期间，与人口特征、注射 和性风险行为，以及参与减少伤害计划 例如针头交换和药物治疗。 目标2. 研究丙型肝炎病毒传播的分子流行病学1） IDU社交网络和2）IDU与其他患者群体之间的关系 社区使用病例对照设计，我们将研究社会 40-50名血清转化为HCV阳性的队列成员（目标1）的网络 （索引受试者），并检查网络中与遗传相关的感染 成员与指标主体的风险行为关系。 风险 网络成员将包括那些使用毒品或有性行为的人。 在索引发布期间与索引主题接触 获得性HCV感染 分子病毒学方法将用于 将风险网络成员分类为相关菌株与不相关菌株。 我们将 我还研究了与扩散相关的社交网络的特征 HCV在网络中的分布，如 网络，网络中存在多个基因型， 网络中存在感染多种毒株的注射吸毒者。 此外，我们还将比较HCV毒株之间的遗传距离 与社区其他患者群体相比， 评估注射吸毒者和其他病人之间的传播程度。 本研究的意义在于它对我们的 了解HCV流行病学和危险因素，可用于 制定适当的预防战略。 该研究还将增加 通过测量事件来认识HCV问题的严重性 感染和调查注射吸毒者是否是一个重要来源 丙型肝炎病毒传播到其他人群。

DESCRIPTION: (Applicant's Abstract) The problem of endemic hepatitis C virus (HCV) infection in injection drug users (IDUs) is only beginning to be recognized, although HCV infection rates in IDUs consistently exceed the incidence of HIV or HBV. Research to date has not provided the basis for development of urgently- needed HCV prevention programs. With the long-term goal of contributing to knowledge that will lead to interventions to prevent HCV infection in drug injectors, the specific aims of this study are the following: Aim 1. Describe the epidemiology of HCV infection in IDUs. We will measure HCV incidence in a cohort of 400 HCV-seronegative IDUs over a three year period, in relation to demographic characteristics, injection and sexual risk behaviors, and participation in harm reduction programs such as needle exchange and drug treatment. Aim 2. Study the molecular epidemiology of HCV transmission 1) within IDU social networks and 2) between IDUs and other patient groups in the community. Using a case-control design, we will study the social networks of 40-50 cohort members (Aim 1) who seroconvert to HCV-positive (index subjects), and examine genetically related infections in network members in relation to risk behavior with the index subject. Risk network members will include those who used drugs with or had sexual contact with the index subject during the time period when the index acquired HCV infection. Molecular virology methods will be used to classify risk network members as related vs. unrelated strains. We will also study characteristics of social networks associated with diffusion of HCV in the network, as indicated by overall HCV-prevalence in the network, the presence of multiple genotypes in the network, and the presence of IDUs in the network who are infected with multiple strains. Additionally, we will compare the genetic distance between HCV strains in IDU subjects to that in other patient groups in the community, to assess the degree of transmission between IDUs and other patients. The significance of this study will be its contribution to our understanding of HCV epidemiology and risk factors that may be used to develop appropriate prevention strategies. The study will also increase awareness of the magnitude of the problem of HCV by measuring incident infections and investigating whether IDUs represent an important source of HCV transmission to other segments of the population.