江门市吸毒人群高危行为及HIV、梅毒、HBV、HCV感染状况调查

目的了解江门市吸毒人群的高危行为及HIV、梅毒、HBV、HCV感染状况,为制定艾滋病预防控制策略提供科学依据。方法2003~2004年对江门市戒毒所、看守所、劳教所的吸毒人员进行匿名问卷调查,同时进行HIV、乙型病毒性肝炎(HBV)、丙型病毒性肝炎(HCV)及梅毒血清学检测。结果共调查吸毒者1168人,男性占87.93%,平均年龄29.3岁,其中21~40岁人群占总人数的82.19%。87.41%为静脉吸毒者,其中83·84%曾经有共用针具吸毒行为,40.67%的人在最近3个月内有婚外性行为,50.94%的人承认在最近3次性行为中没有使用安全套。1168名吸毒者的HIV、梅毒、HBV、HCV感染率分别为6.68%、9.25%、18.06%、69.69%。结论江门市吸毒人群HIV感染率较高,高危行为普遍,应加强对该人群的宣传和干预,防止HIV从该人群向一般人群扩散。     

Prevalence of serologic markers of HBV, HDV, HCV and HIV in non-injection drug users compared to injection drug users in Gran Canaria, Spain

Injection drug use (IDU) is one of the most significant risk factors for viral hepatitis (B, D and C) and human immunodeficiency virus (HIV) infection. However, there is little information about the risk of infection among non-injection drug users (non-IDUs). The present study was designed to perform several objectives: (a) to evaluate the prevalence of serological markers of hepatitis B, D, C virus and HIV in IDU and non-IDU patients; (b) to compare the prevalence of these markers between both groups; (c) to identify risk factors for HCV and HIV in this population; and (d) to correlate the presence of HCV and liver function. A total of 385 consecutive patients (122 IDUs and 263 non-IDUs), admitted to the Drug Dependency Treatment Unit at the Hospital Insular of Gran Canaria between 1993 to 1994, were included in the study. The serological markers of HBV, HDV, HCV and HIV were determined by ELISA and immunoblot methods. In all cases we also measured syphilis tests (RPR and FTAabs), serum aminotransferases and serum gammaglutamiltranspeptidase. Compared to the non-IDU, the IDU group presents a higher prevalence of antiHBc (55.0% vs. 20.7%, p < 0.0001), antiHCV (87.6% vs. 35.3%, p < 0.0001) and antiHIV (21.8% vs. 2.7%, p < 0.0001). There was no significant difference in RPR positivity (0.9% vs. 4.9%, p = 0.06). Delta infection was only detected in injection drug users, and the prevalence was low. Using logistic regression, the only risk factors associated with antiHCV positivity were injection drug addiction (OR: 9.2, 95% CI: 4.9–17.0) and antiHBc positivity (OR: 5.5, 95% CI: 3.0–9.9). Similarly, the associated risk factors for HIV were injection drug addiction (OR: 5.9, 95% CI: 2.3–15.0) and antiHBc positivity (OR: 3.8, 95% CI: 1.5–9.2). However, no correlation was found between antiHCV positive and antiHIV or between these markers and RPR positivity. Patients positive for antiHCV showed significant elevations in aspartate aminotransferase and alanine aminotransferase levels, when compared with patients negative for antiHCV: 65.0 vs. 39.2 U.l (p < 0.001) and 88.4 vs. 40.3 U/l (p < 0.001), respectively. We conclude that drug users have an elevated prevalence of HCV, HBV and HIV infection, even if drug use is only inhalated. On the other hand, the main risk factors associated with HCV and HIV are injection drug addiction and exposure to hepatitis B virus. Finally, in the study population, liver dysfunction is closely related to HCV infection.     

静脉药瘾者HIV重叠HBV/HCV感染研究

目的探讨人类免疫缺陷病毒（HIV）重叠乙型肝炎病毒（HBV）/丙型肝炎病毒（HCV）感染时,HIV对机体T辅助细胞亚群的影响及HBV/HCV核酸载量的变化.方法以静脉药瘾者（IVDUs）为研究对象,采用ELISA、免疫层析法和PCR法检测病毒感染指标,用ELISA法和间接免疫荧光法检测T细胞亚群.结果 IVDUs的CD3、CD4细胞、干扰素（IFN）-γ和白细胞介素（IL）-4产生减少,IVDUs存在HIV感染时CD3、CD4细胞和IFN-γ产生进一步降低,HIV感染与HBV-DNA和HBeAg表达相关.结论 IVDUsT细胞亚群功能减弱,HIV促进HBV复制,重叠感染可进一步干扰辅助性T细胞（TH）1/T2细胞平衡,降低机体细胞免疫功能.     

张掖市吸毒人员HIV、梅毒、HBV及HCV感染现状调查

目的:分析张掖市吸毒人员人口学基本特征和行为学特征;了解该人群艾滋病病毒(HIV)、梅毒、乙型肝炎病毒(HBV)表面抗原(HBsAg)、丙型肝炎病毒(HCV)感染现状,为制定控制策略和措施奠定基础。方法:采用统一的吸毒者登记表对吸毒人员进行问卷调查,采集静脉血进行检测。结果:吸毒人员年龄主要集中在31~40岁61.24%(828/1352),年龄最小者17岁,最大者62岁。初中及以下文化程度82.88%,无业者52.30%,未婚者48.73%。静脉吸毒者22.2%,静脉吸毒共用针具比例33.90%,通过钱或毒品与他人发生性关系者19.10%,且从未使用安全套者高达59.11%。血清学监测结果显示:H IV抗体、梅毒、HBsAg、抗-HCV阳性率分别为0.15%,3.91%,11.15%,19.29%。抗-HCV阳性率由2004年的16.56%上升至2007的23.45%,呈逐年上升趋势(2χ=12.73,P<0.01)。114份抗-HCV阳性血清HCVRNA阳性66份,阳性率57.89%。结论:该人群高危行为突出,是艾滋病性病传播的桥梁人群,也是采取干预措施的重点人群,当务之急应继续扩大美沙酮门诊工作规模,迅速扩大治疗覆盖面,让更多的吸毒人员接受美沙酮替代治疗,同时大力推广针具交换,开展转介服务,以遏制H IV、梅毒、HBV、HCV在该人群中的进一步扩散蔓延。     

A longitudinal study on the incidence and transmission patterns of HIV,HBV and HCV infection among drug users in Amsterdam

In the present study data on the incidence of HBV and HCV were used to indicate the prevalence of and trends in risk behavior, assuming that drug users (DUs) who become infected with HBV or HCV are also at risk for infection with HIV. In addition, we determined to that extent the transmission patterns of HIV, HBV and HCV differed. DUs were selected from a cohort study in Amsterdam, had at least one follow-up visit between December 1985 and September 1989 and reported never to have had homosexual contacts. Among 305 DUs, of whom 70% injected recently, the prevalence of HIV, HBV and HCV were 31%, 68% and 65% respectively. These prevalences were strongly interrelated and the same risk factors were found. The cumulative incidence of either HIV or HBV or HCV was 30% among prevalent HIV-negatives. Despite a previously reported reduction in risk behavior, only the HIV incidence tended to decrease initially, and after 1986 the incidences of HIV, HBV and HCV remained disturbingly high and stable (mean: 4, 9 and 10 per 100 person-years, respectively). As at present HBV appears to be transmitted more heterosexually than HIV in our study group and the HIV-epidemic may follow the HBV-epidemic in its transmission patterns, preventive activities targeted at both injecting and sexual behavior should be expanded.     

317名吸毒人员吸毒行为与艾滋病、乙型肝炎、丙型肝炎及梅毒感染状况分析

目的 了解广东省中山市吸毒人员的吸毒行为与HIV，HBV，HCV，梅毒的感染状况。方法 采用统一调查表对中山市某强制戒毒所于2001年10-11月新入新的317名吸毒人员进行问卷调查。并采血样检测HIV抗体，HBsAg,HCV抗体，梅毒抗体。结果 317名吸毒中，单纯口吸占35.33%，静脉注射占64.67%，其中共用针具率46.34%，吸毒人员中HIV，HBV，HCV和梅毒感染率分别为2.84%,20.82%,66.24%和2.84%。单纯口吸未检出HIV感染，HCV感染，HCV感染率静脉注射高于口吸毒品，不同吸毒方式HBV，梅毒感染率差异无显性。结论 应在吸毒人群中持续开展艾滋病，丙型肝炎知识的宣传和干预措施。     

中国大陆吸毒人群HIV、HBV、HCV感染状况及其相关因素的Meta分析

目的掌握中国大陆吸毒人群的基本情况,以及该人群中艾滋病病毒（HIV）、乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）的流行状况,探讨其相关因素。方法通过相关检索策略查找已经发表的针对中国大陆吸毒人群HIV、HBV、HCV感染状况的相关文献,整理并制作成数据库进行Meta分析。结果我国吸毒人群HIV、HBV、HCV的感染率分别为3．3％、25．0％、50．4％;吸毒人群中HIV、HBV、HCV感染与性别并无明显关联;注射吸毒是吸毒人群HIV、HBV、HCV感染的危险因素;长期吸毒可以促进HCV在吸毒人群中的流行。结论应加强对吸毒人群的健康教育和行为干预,尤其是注射吸毒人群,防止HIV、HBV、HCV在其中扩散。     

High HCV seroprevalence and HIV drug use risk behaviors among injection drug users in Pakistan

Introduction  

HIV and HCV risk behaviors among injection drug users (IDUs) in two urban areas in Pakistan were identified.     

Infection status and risk factors of HIV,HBV, HCV,and syphilis among drug users in Guangdong,China - a cross-sectional study

Background  

China has witnessed a remarkable increase in sexually transmitted infections (STIs) and HIV. The study is to assess the prevalence of HIV, HBV, HCV and syphilis and related risk factors among drug users in mandatory detoxification center Qingyuan, Guangdong, China.     

哨点监测吸毒人群HIV、HCV及梅毒检测结果分析

目的:了解三亚市近年吸毒人群HIV、HCV、梅毒感染状态,以采取有效的预防和干预措施。方法:对三亚市哨点监测的1236名吸毒人员进行HIV、HCV及梅毒血清学检测。结果:1236名吸毒人群中HIV抗体阳性19例,阳性率1.54%,HCV抗体阳性1074例,阳性率86.89%,梅毒抗体阳性44例,阳性率3.56%,HCV/梅毒重叠感染41例,阳性率3.32%。结论:吸毒人群是HIV、HCV、梅毒感染的高危人群,采取切实可行的宣传教育和防治干预措施非常重要。     

HCV,HIV, HBV and HDV infections in intravenous drug addicts

Hepatitis viruses and the acquired immunodeficiency viruses often infect intravenous drug addicts (IVDAs). Our study includes 255 IVDAs (26 females and 229 males, aged 20–35 years) from Cagliari. Of 255 subjects examined, 207 (81.1%) were positive for anti-HCV and 84 (32.9%) for anti-HIV. Nineteen (7.4%) subjects were HBsAg carriers, and 12 of these (63%) had an HDV super-infection. Markers of previous HBV infections were tested in 223 cases and 137 (61.4%) were found positive; of these 14 (10.2%) also had HDV infection. Of the 223 drug addicts examined for all infection markers, 18 (8%) were negative to all markers, 46 (20.6%) were positive to only one, 89(39.9%) were positive to two, 64 (28.7%) to three and 6 (2.6%) were positive to all. Subjects with a single infection were significantly fewer than those with multiple infections. The correlations studied among the various markers did not point out any statistically significant associations. Even so, a previous HBV infection was more common while active HBV/HDV infections were less common among subjects with anti-HCV; HDV infection was more common among HIV-positive subjects. In HBsAg carriers neither HBV-DNA nor HCV-RNA was detected; HCV-RNA was found more frequently in anti-HIV positive subjects than in subjects with the anti-HCV isolate.     

HIV and HCV testing for young drug users in Rhode Island

Young injection drug users (IDU) are at risk for both human immunonodeficiency virus (HIV) and Hepatitis C infections (HCV). Rates of HIV testing have been widely documented, but limited information exists regarding HCV screening rates. Among a community sample of 86 IDUs, aged 18–25 years in Rhode Island, 87.2% reported ever testing for HIV versus 51.2% for HCV (p < .001). Young injectors were under-screened for HCV compared with the far less prevalent HIV infection.     

清远市监狱服刑人员艾滋病、乙型肝炎、丙型肝炎和梅毒感染情况调查

目的了解监狱服刑人员艾滋病、乙型肝炎、丙型肝炎和梅毒的感染情况。方法2005年1月对清远市英德监狱服刑人员进行整群抽样,调查其高危行为史,并抽取血标本进行HIV抗体、HBsAg、HCV抗体和梅毒血清学检测。结果共调查4 973名服刑人员,有吸毒经历者占8.57%,其中92.96%为静脉吸毒;有性乱经历者占39.84%。共检出HIV抗体阳性者15例,年龄为20~49岁,其中HIV、HBsAg和HCV三重感染者9例;HBsAg阳性检出率为2.03%,HCV抗体阳性率为9.63%,梅毒阳性率为0.62%。有静脉吸毒经历服刑人员的HIV抗体、HBsAg、HCV抗体和梅毒总阳性率分别为2.78%1、1.36%、46.46%和3.28%,高于无静脉吸毒经历者(均P<0.01);有静脉吸毒及性乱经历者的梅毒阳性率为3.46%,高于仅有性乱经历者(P<0.01);单纯性乱或单纯供血与无高危行为经历者之间的HBsAg和HCV抗体阳性率差异无统计学意义(P>0.05)。结论监狱服刑人员有较高的艾滋病、乙型肝炎、丙型肝炎病毒和梅毒感染率,静脉吸毒和性乱是感染的主要因素;应加强对监狱服刑人员的疾病监测及行为干预,降低其重返社会后扩散和传播传染病的危险性。     

福州市美沙酮替代治疗人群丙肝、乙肝、艾滋病和梅毒感染调查

目的了解美沙酮替代治疗者丙肝、乙肝、艾滋病及梅毒感染情况及高危因素,为制定防控措施提供依据。方法对接受美沙酮替代治疗的1 149例进行问卷调查;采集静脉血标本,用ELISA法检测抗-HCV、HBV标志物、抗-HIV和梅毒抗体。结果 1 149例中男性检出抗-HCV 569例(49.5%),HBsAg阳性25例(2.2%),抗HIV阳性31例(2.7%),梅毒抗体阳性5例(0.4%)。抗-HCV阳性者中,女性感染率(63.4%)高于男性(46.8%),感染率最高为30~49岁组。注射吸毒为HCV感染的高危因素。93例HCV感染者中,HCV RNA大于2.7log10拷贝/mL有61例(65.6%)。61例HCV RNA阳性标本中,基因型以1b型为主(65.7%)。结论美沙酮替代治疗的吸毒人群中,抗-HCV阳性率远超自然人群,尤以注射吸毒者感染率为高;其HCV基因型与福建自然人群感染丙肝基因型一致;65.6%HCV感染者存在HCV RNA高复制,需要进行抗病毒治疗。     

我国15个城市吸毒人群HIV、梅毒螺旋体、丙型肝炎病毒感染现况

目的 了解中国卫生部-比尔盖茨基金会AIDS防治国际合作项目(简称中盖AIDS项目)实施地区15个城市吸毒人群的HIV感染现况及相关行为特征.方法 查询公安部门资料、结合专家咨询,了解吸毒人员规模,问卷调查了解吸毒人群AIDS行为相关特征,采血检测HIV、梅毒螺旋体及丙型肝炎病毒(HCV)感染状况.结果 中盖AIDS项目地区15个城市2007年登记在册和估计吸毒人数分别为176 004、477 989名,吸食毒品以海洛因和冰毒为主,AIDS防治知识知晓率为41.0%(2685/6155),其中杭州97.6%(410/420)、青岛85.5%(342/400)、武汉69.7%(308/442)、昆明63.8%(255/400)、上海45.4%(237/522)、西安44.5%(178/400)、南京38.8%(155/400)、北京36.5%(237/650)、广州 29.5%(122/413)、哈尔滨25.4%(114/447)、海口23.8%(96/402)、重庆22.4%(90/401)、三亚20.0%(80/400)、天津16.2%(41/253)、沈阳9.8%(20/205),各城市之间AIDS防治知识知晓率差异具有统计学意义(x2=1482.833,P＜0.05).最近1次共用注射器吸毒率仅为10.8%(665/6155),其中杭州10.8%(45/420)、重庆26.4%(106/401)、广州2.6%(11/413)、沈阳31.3%(64/205)、上海0.4%(2/522)、昆明10.8%(43/400)、北京10.6%(69/650)、天津5.4%(14/253)、西安3.3%(13/400)、武汉17.9%(79/442)、三亚20.0%(80/400)、海口2.2%(9/402)、哈尔滨8.5%(38/447)、南京21.4%(86/400)、青岛1.5%(6/400),城市间差异有统计学意义(x2=483.044,P＜0.05);仅5.0%(8737/176 004)的吸毒人员和1.2%(155/12 611)HIV阳性的吸毒人员参加了针具交换;现场调查HIV、梅毒螺旋体及HCV感染率分别为2.76%(155/5620)、3.38%(190/5620)和32.35%(1818/5620),各城市HIV感染率为:杭州0.4%(1/273)、重庆7.5%(30/401)、广州2.9%(12/413)、沈阳0.5%(1/205)、上海0.32%(1/316)、昆明16.25%(65/400)、北京2.6%(16/624)、天津2.0%(5/253)、西安1.25%(5/400)、武汉0.24%(1/411)、三亚1.75%(7/400)、海口0.2%(1/402)、哈尔滨1.1%(5/447)、南京1.1%(3/275)、青岛0.5%(2/400),城市间差异有统计学意义(x2=354.203,P＜0.05).结论 15个城市中重庆、昆明等部分城市吸毒人群HIV感染率超流行警戒线,但总体稳中有降,因共用注射器感染HIV的危险性处于下降趋势,但要防范新型毒品如冰毒带来的不安全性行为传播HIV的危险.     

宁夏西夏区吸毒人员HIV、HCV和梅毒感染状况分析

目的:了解银川市西夏区静脉吸毒人员感染HIV、HC和梅毒的现状,为在该人群中提供相应的预防措施提供科学依据。方法:对吸毒人员进行问卷调查,并采集血样进行HIV、HCV和梅毒的检测。结果:386名吸毒人员中,HIV抗体、HCV抗体和梅毒感染率分别为2.07%、77.46%、5.44%。本次调查中8例HIV阳性吸毒者中有两例是三重感染。结论:吸毒人员中HIV及HCV的感染情况严重,应普及美沙酮维持治疗等措施来控制这些疾病在吸毒者中的流行。     

广州市1324名吸毒人员HIV、HBV、HCV及梅毒感染状况调查

目的了解广州市吸毒人群HIV、HBV、HCV及梅毒感染状况,为制定针对该地区吸毒人群常见传染病的防治措施提供依据。方法于2009年7月—2011年6月,抽取广州市某戒毒所收入的1 324例吸毒人员静脉血,检测HIV、HCV和梅毒抗体以及HBV表面抗原。结果 1 324例吸毒人群中,HIV抗体阳性74例,阳性率4.2%;乙肝表面抗原阳性率12.2%,丙肝抗体阳性率40.5%,梅毒螺旋体明胶颗粒凝集试验(TPPA)阳性率6.1%。21.8%的吸毒人员同时检出2种传染病,2.2%的吸毒者同时检出3种传染病。结论广州市吸毒人群中HCV、HBV、梅毒及HIV仍存在较高的感染率,应继续重视对该人群的监管监测及宣传教育。     

浙江省台州市HIV感染者中HBV和HCV及EBV合并感染率研究

目的探讨浙江省台州市人类免疫缺陷病毒(HIV)感染者中乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)及EB病毒(EBV)合并感染率,并分析其影响因素。方法对台州市所有可定期随访的167例HIV感染者进行流行病学调查,其中男性113例,女性54例;平均年龄40岁。采用ELISA方法检测确定其HBV、HCV和EBV的血清阳性率。利用单因素logistic回归模型分析数据。结果研究经异性性接触感染HIV 115例(68.9%)。HBV、HCV、EBV的感染率分别为7.2%、21.0%和93.4%;有2例HIV感染者同时感染了HBV、HCV、EBV等3种病毒;有35例(21.0%)HIV感染者同时感染了HCV和EBV。单因素logistic回归分析显示:HIV感染者中,农民的HBV感染率高于从事商业服务者,经血液途径感染HIV者的HCV感染率高于经性途径感染HIV者,已婚者的EBV感染率高于未婚者。结论当地HIV感染者中存在一定比例的HBV、HCV和EBV共感染者,不同特征的HIV感染者中HBV、HCV和EBV的共感染率不同。     

毒品混用人群高危特征及其艾滋病、梅毒、丙型肝炎感染现况

目的 掌握吸毒人群高危特征,为防病干预工作提供科学参考。方法 对650名吸毒人员进行调查并采学血检测HIV、梅毒、HCV感染状况,分为传统毒品组、新型毒品组以及传统毒品和新型毒品混用组进行分析。结果 新型毒品、传统毒品及毒品混用者分别占比59.5%、25.5%、14.9%。毒品混用组:以在婚或同居者为主（χ2 = 14.580,P = 0.006）,更易于因为同伴影响染毒（χ2 = 7.269,P = 0.026）,更多因为无所事事而染毒（χ2 = 15.690,P＜0.001）;更多是在旅店/宾馆（χ2 = 11.113,P = 0.004）、歌舞厅/夜总会（χ2 = 12.958,P = 0.002）、洗浴中心（χ2 = 14.196,P = 0.001）这些公共场所吸毒,更易于共用针具（χ2 = 39.299,P＜0.001）;吸毒后性行为比例更高（χ2 = 7.299,P = 0.026）,较易与商业性伴发生性行为（χ2 = 10.027,P = 0.007）,安全套使用比例较低（χ2 = 12.281,P = 0.015）;HIV感染率较高为2.1%（χ2 = 6.554,P = 0.038）、梅毒感染率较高,为14.4%（χ2 = 15.522,P＜0.001）;丙型肝炎感染率为61.9%,低于传统毒品组但是高于新型毒品组（χ2 = 206.974,P＜0.001）。结论 毒品混用人群存在更高的HIV及梅毒感染风险,是需要重点关注和干预的一类人群。