Etiology and Prevention of Blood borne Viruses in IDUs

描述(申请人提供)：血液传播疾病的病因和预防 注射吸毒者中的病毒感染尚未完全 具有特征性，关于哪些注射做法仍然存在许多问题 可能会导致I型感染。注射吸毒者中的病毒性肝炎感染是 最常见的81例人胎脑L感染；低发区 L所致静脉吸毒者的艾滋病毒流行环境、发病率和死亡率 肝炎病毒感染可能超过艾滋病毒感染。丙型肝炎病毒(HCV)是 在吸毒人群中高度流行，并更有效地传播L 关于注射比艾滋病毒。由于丙型肝炎病毒的性行为传播相对较少， 可作为直接经皮穿刺术的一个高度敏感的生物标志物。 在毒品注射器中暴露于这些感染，并可能导致 了解通过注射传播其他感染的机制 练习。我们研究的长期目标是促进对 静脉吸毒人群中HIV和肝炎感染的流行病学、病原学和预防 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.检查西雅图的丙型肝炎预防教育的程度 针头交换计划降低了感染丙型肝炎病毒的风险。目标2.衡量标准 丙型肝炎病毒血清转换的风险与特异性注射风险相关 行为，并计算可归因于这些行为的丙型肝炎风险 IDU-人口。目标3.比较对社会不受欢迎或污名化的报道 A-CASI收集的注射和性危险行为 采访者管理的数据收集方法。目标4.评估可行性 以及注射吸毒者的乙肝病毒和丙型肝炎病毒伙伴通知的疾病控制好处。目标 5.研究丙型肝炎报告法的变化是否与 注射吸毒者报告增加。这项研究的意义在于它的潜力 有助于我们了解这些L感染的病原学，以及 探讨了许多与公共卫生有效性相关的实际问题 监测和预防计划。

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.