Non-parenteral transmission of hepatitis C

描述(由申请人提供)：这项建议将为申请人王佳提供病毒传播流行病学研究方面的培训。王博士是委员会认证的身份内科医生，拥有流行病学硕士学位。在华盛顿大学担任研究员期间，她研究了非洲的异性艾滋病传播。该项目形成了对感染传播和获得性流行病学的长期兴趣的基础。这份提案描述了她在丙型肝炎病毒(丙型肝炎病毒)非肠道传播领域的研究兴趣。 在目标1中，我们将以慢性感染患者为研究对象，对唾液和生殖道液中丙型肝炎病毒RNA的流行率和脱落模式进行纵向研究。此外，将收集有关口腔和生殖道炎症情况的信息，以调查此类情况可能增加脱落的假设。在目标2中，我们探讨了在丙型肝炎病毒感染的急性期传播可能更有效的假设。我们将建立早期血清病毒载量动态变化和从当地丙型肝炎病毒阴性静脉注射人群中发现的丙型肝炎病毒感染病例的粘膜脱落模式。最后，在目标3中，我们将通过结合音频计算机辅助调查仪器(ACASI)技术来减少漏报偏差和特定调查技术来减少回忆偏差，来检查拒绝肠道外传播方式的个人的潜在风险因素。静脉吸毒等污名化行为的漏检率将在传统面对面访谈中否认此类风险因素的受试者中确定。丙型肝炎其他潜在的非肠道外危险因素的报告，如鼻内使用可卡因，将与来自普通内科诊所的对照人群进行比较。20%-30%的丙型肝炎感染者的感染模式仍然知之甚少。拟议的研究结果可能会证实可能的传播途径，如性接触，或可能驳斥目前的数据，即相当大比例的感染可能发生在非肠道外。此外，拟议的项目将为王博士提供相当专注的奖学金项目之外的病毒传播研究方面的培训，目的是建立她在该领域的专业知识，并为她提供技能，以进一步开展丙型肝炎和其他病毒传播的独立研究。

DESCRIPTION (provided by applicant): This proposal will provide the applicant, Chia Wang, with training in the epidemiologic study of viral transmission. Dr. Wang is a board certified ID physician with a MS in Epidemiology. During her fellowship at the University of Washington, she studied heterosexual HIV transmission in Africa. This project formed the foundation of a long term interest in the epidemiology of transmission and acquisition of infection. This proposal describes her research interests in the area of non-parenteral transmission of hepatitis C virus (HCV). In Aim 1, we will study individuals with chronic infection in a longitudinal study of the prevalence and pattern of shedding of HCV RNA in saliva and genital tract fluids. Furthermore, information about oral and genital tract inflammatory conditions will be collected to investigate the hypothesis that such conditions may increase shedding. In Aim 2, we explore the hypothesis that transmission may occur more efficiently during the acute phases of HCV infection. We will establish early serum viral load dynamics and mucosal shedding patterns in incident cases of HCV identified from a local cohort of HCV negative current IDUs. Finally, in Aim 3, we will examine potential risk factors in individuals who deny parenteral modes of transmission by incorporating audio computer-assisted survey instrument (ACASI) technology to reduce under-reporting bias and specific survey techniques to reduce recall bias. The under-reporting rate of stigmatized behaviors such as intravenous drug use will be determined in subjects who deny such risk factors in traditional face-to-face interviews. Reporting of other potential non-parenteral risk factors for hepatitis C, such as intranasal cocaine use, will be compared to that of a control population derived from general medicine clinic. The mode of infection in 20-30% of hepatitis C-infected individuals remains poorly understood. The findings of the proposed research study may confirm suspected transmission routes such as sexual exposure, or may refute current figures suggesting that a substantial proportion of infections may occur non- parenterally. In addition, the proposed project will provide Dr. Wang with training in viral transmission research beyond her rather focused fellowship project, with the goal of establishing her expertise in this field and providing her with skills to pursue further independent studies in the transmission of hepatitis C and other viruses.