南宁市静脉注射吸毒人群HIV-1基因亚型及耐药性分析

目的 了解南宁市静脉注射吸毒人群（IDUs）中HIV-1流行基因亚型及其耐药性,为辖区艾滋病防治策略制定提供科学依据。方法 收集2017年南宁市静脉注射吸毒人员HIV感染者血浆样本总共68份,提取病毒核糖核酸(RNA),通过巢式PCR对HIV pol基因片段进行扩增测序,构建系统进化树进行基因分型,并将序列提交至美国斯坦福大学HIV耐药数据库分析,利用pol基因测序结果分析HIV-1亚型和耐药性情况。结果 68份血浆样本中巢式PCR成功扩增基因片段62份,系统进化分析显示检出3种HIV-1重组基因亚型, CRF_01-AE亚型占72.6% (45/62)、CRF_07-BC亚型占12.9% (8/62)、CRF_08-BC亚型占14.5% (9/62) ,CRF01_AE 型为主要流行亚型。χ²检验分析显示在性别、年龄、民族、婚姻4个人口学特征中62份样本HIV-1亚型组成差异无统计学意义（P>0.05）。62份样本中3例CRF_08-BC亚型发现T69S耐药突变,1例CRF_01-AE亚型发现L210W突变,1例CRF_07-BC亚型发现A71V突变。结论 南宁市IDUs人群HIV-1感染者中至少存在3种HIV-1基因亚型流行,CRF_01-AE重组型为优势流行株,研究中出现的耐药突变位点为低度耐药突变位点,应密切监视其流行趋势。     

Prevalence of HIV infection among intravenous drug users in the United States

We reviewed 92 published and unpublished studies of the prevalence of infection with the human immunodeficiency virus (HIV) among intravenous drug users (IVDUs) in the United States. Human immunodeficiency virus seroprevalence among IVDUs in drug treatment programs in the United States ranged from 0% to 65%. Seroprevalence was highest in the Northeast (10% to 65%) and Puerto Rico (45% to 59%); lower in the South Atlantic (7% to 29%) and in the metropolitan areas of Atlanta, Ga (10%), Detroit, Mich (7% to 13%), and San Francisco, Calif (7% to 13%); and 5% or less in other areas of the West, the Midwest, and the South. Among IVDUs seen in drug treatment programs, risk of infection was not associated with gender or age but was associated with black and Hispanic ethnicity, male homosexual orientation, and certain intravenous drug-use practices. Cross-sectional and cohort studies indicated increases in seroprevalence of between 0% and 14% per year among IVDUs in treatment. We estimated that between 61,000 and 398,000 IVDUs in the United States were infected with human immunodeficiency virus, or 5% to 33% of the IVDU population. High rates of infection among IVDUs in treatment in the Northeast indicate the potential for rapid spread in regions where rates are currently low. An urgent need exists to monitor human immunodeficiency virus infection levels and trends more widely and to develop effective programs to reduce the further spread of human immunodeficiency virus infection among IVDUs.     

静脉注射毒品者的血源性感染

目的了解静脉吸毒者的血源性全身感染状况，以指导诊断和治疗。方法将2001年1月-2004年12月收治的18例静脉吸毒者的全身感染作回顾性分析。结果全部病例均有右心感染性心内膜炎和多发性肺脓肿，伴发肺栓塞4例、多发性脑脓肿2例、丙型肝炎3例、乙型肝炎1例。血培养结果：金黄色葡萄球菌阳性13例，其中1例同时白色念珠菌阳性；铜绿假单胞菌阳性2例；草绿色链球菌阳性3例。予青霉素、阿米卡星、头孢他啶、去甲万古霉素等治疗6周左右，除伴发脑脓肿的2例死亡、伴白色念珠菌感染1例自动出院外，余均治愈。结论静脉吸毒者血源性全身感染常见有右心感染性心内膜炎、多发性肺脓肿、肺栓塞、多发性脑脓肿、丙型肝炎、乙型肝炎等，其中脑脓肿尤具致命性。血培养阳性率高，经合理治疗后效果较好。     

Hepatitis C virus in intravenous drug users

Sera from 172 intravenous drug users were tested for the presence of antibodies to hepatitis C virus (anti-HCV). The results were analysed in relation to aspects of the history of drug use and evidence of liver disease. The presence of anti-HCV was strongly associated with duration of intravenous drug use. Two-thirds of patients were anti-HCV seropositive within two years of commencing regular intravenous drug use, and there was 100% seropositivity among people injecting drugs for more than eight years. Seropositivity for hepatitis C virus closely paralleled exposure to hepatitis B virus, which was also endemic in this population. In contrast, only one patient tested positive for antibodies to the human immunodeficiency virus. The presence of anti-HCV correlated poorly with biochemical markers of hepatitis. About half the patients with anti-HCV had normal serum levels of alanine aminotransferase, whereas an abnormal liver biochemistry was frequently observed in anti-HCV seronegative subjects. Previous studies of non-A, non-B hepatitis that have used abnormal liver biochemistry as a marker have underestimated the prevalence of chronic hepatitis among intravenous drug users; the use of a specific screening test reveals that infection with hepatitis C virus is very common in this population.     

HIV risk behaviour in Irish intravenous drug users

The aim of the study was to measure HIV prevalence and risk behaviour in 185 Irish Intravenous Drug Misusers. Information was obtained by application of a standardised WHO questionnaire covering HIV risk behaviour in the preceding 6 months. HIV serostatus was obtained by saliva/ blood sample testing. One hundred and 3(55.7 per cent) shared and 114 (61.6 per cent) lent used injecting equipment in the previous 6 months. 97 (94.2 per cent) of those who shared always cleaned the needles before use but only 48 (49.5 per cent) of these always cleaned in an efficient manner. One hundred and 14(79.2 per cent) males and 28 (68.3 per cent) females reported heterosexual activity in the preceding 6 months. On examination sexual risk behaviour was found to be high. 50.5 per cent of males and 63 per cent of females never used condoms with regular partners. 32.6 per cent of males never used condoms with casual partners. The large majority of partners of male I.D.U’.s (both regular and casual) were non injectors. Therefore there is potential for sexual spread of HIV into the non-injecting heterosexual population. Conversely the vast majority of partners of female IDU’s were injectors. This suggests that female IDU’s are at higher risk of HIV infection than their male counterparts. HIV prevalence in the study group was 8.4 per cent. Implications of results for future intervention are discussed.     

Epidemiology of Hepatitis B, C, D and G Viruses and Cytokine Levels among Intravenous Drug Users

Viral hepatitis presents a major global publichealth concern. HBV and HCV, in particular ,were the causative agents responsible for parenter-ally transmitted diseases[1 ,2]. IVDU represent aspecial subgroup of the population who oftenshared contaminated needles for intravenous drugsinjection[3].Opiate use was knownto alter i mmunefunction and had i mmunosuppressive effects thatmay modify T-lymphocyte subpopulations .IVDUwere subject to transmittable blood-borne patho-gens . The pathogens…     

Human immunodeficiency virus infection in diabetic intravenous drug users

OBJECTIVE.--To evaluate the association between diabetes and human immunodeficiency virus (HIV) seroprevalence in a population of intravenous (IV) drug users. DESIGN.--Cross-sectional survey in a cohort of IV drug users. SETTING.--Community-based study clinic. SUBJECTS.--The study included 2921 individuals with a history of IV drug use in the past 10 years; over 90% had injected drugs in the past year and 77% in the past month; only 15% were receiving drug treatment. OUTCOME MEASURES.--The HIV seroprevalence among IV drug users with and without a history of diabetes. RESULTS.--Those IV drug users with a history of diabetes had significantly lower HIV seroprevalence (9.8%) than nondiabetic IV drug users (24.3%; P = .03). Despite similar duration and intensity of drug use and sexual practices, diabetic IV drug users tended not to share injection paraphernalia and were less likely to attend shooting galleries than nondiabetic IV drug users. CONCLUSION.--Our data suggest that the apparent protective effect of diabetes against HIV infection in IV drug users is most likely due to their safer injection practices afforded by their ready access to sterile injection equipment.     

静脉吸毒人员共用针具行为调查

目的了解静脉吸毒人群的针具共用情况并探索可能的影响因素。方法采用横断面研究方法于2011年5-6月对广东省某戒毒所内静脉吸毒人员进行一对一的问卷调查,调查内容包括一般人口学信息、吸毒相关行为、性行为及艾滋病综合防治知识。结果调查的267名男性静脉吸毒人员的平均年龄为(38±6.1)岁,首次注射吸毒的平均年龄为(28±6.9)岁。30.71%的被调查者曾有过共用针具行为,被调查者使用的毒品种类主要是海洛因。Logistic回归分析表明,与别人一起吸毒(OR=3.62,95%CI=1.77-7.37)以及共用过辅助器具者(OR=13.48,95%CI=6.66-27.27)是共用针具的危险因素。结论共用针具行为普遍存在于静脉吸毒人群中,相关部门应采取有效管理措施,以减少该人群中高危行为的发生。     

新疆静脉吸毒者中TTV、HBV和 HCV感染情况分析

目的:探讨新疆静脉吸毒者中输血传播病毒 (TTV)、乙型肝炎病毒 (HBV)、丙型肝炎病毒 (HCV)感染的特点 ,为防止感染提供理论依据。 方法:采用套式 PCR技术检测 10 2例静脉吸毒者 (IVDUs)血清中 TTV-DNA,用酶联免疫吸附试验 (EL ISA)检测 HCV抗体 (抗 HCV)及 HBV血清学标志物 ,根据 TTV- DNA检测结果分为 TTV - DNA阳性组和阴性组 ,比较两组人群的 HBV、HCV及 HBV/HCV感染情况。结果:静脉吸毒者 TTV-DNA阳性组和阴性组在民族、年龄、性别、吸毒时间、吸毒剂量、有无多性伴侣、HCV和 HBV病毒混合感染等方面无统计学差异 ,而在是否共用注射器上差异有统计学意义 (P <0 .0 5 )。 33例 TTV- DNA阳性静脉吸毒者中 ,7例为单纯 TTV感染 ,2 6例重叠 HCV或 HBV感染 ,其中 TTV、HCV、HBV三重感染 8例。结论 :TTV、HCV在新疆静脉吸毒者中有较高的阳性率 ,静脉吸毒人群是 TTV、HCV感染的高危人群。 TTV可以单独感染 ,但与 HBV、HCV的重叠感染率也较高。     

HIV-associated risk behaviour among drug users at drug rehabilitation centres

A cross-sectional study to determine the prevalence of Human Immunodeficiency Virus (HIV) and HIV-associated risk behavior was conducted in February 1998 among 6,324 drug users in 26 drug rehabilitation centres in Malaysia. The majority of respondents were males (97.3%) and Malays (77.8%), administered drugs intravenously (64.6%) and of these 65.4% shared needles. About 78.1% had sexual exposure, of which 55.1% had sex with girl friends, 31.3% with prostitutes and 4.6% with male partners. The HIV prevalence rate in the group was 12.1% and significantly high among injecting drug users (IDU); those sharing needles; those who started addiction at a young age (10-15 years); those who had sexual exposures and had sex with prostitutes.     

Cocaine use and HIV infection in intravenous drug users in San Francisco

We assessed risk factors for human immunodeficiency virus (HIV) infection in 633 heterosexual intravenous drug users. The HIV seroprevalence was 26% in blacks, 10% in Hispanics, and 6% in whites. Intravenous cocaine use significantly increased the risk of HIV infection, with a seroprevalence of 35% in daily cocaine users (odds ratio, 6.4; 95% confidence interval, 3.0 to 13.3). Black subjects were more likely to use cocaine regularly. Drug use in shooting galleries and sharing of drug injection equipment were also associated with HIV infection and were more common in cocaine users. By multivariate analysis, black race, daily cocaine injection by blacks and Hispanics, all other cocaine injection, heavy use prior to entry into methadone treatment by blacks, and use of drugs in shooting galleries were independent predictors of HIV infection. Methadone therapy was associated with substantial reductions in heroin use and some reduction in cocaine use, but 24% of cocaine users receiving methadone began or increased cocaine injection after entry into treatment.     

HIV-1 infection among intravenous drug users in Manhattan, New York City, from 1977 through 1987

Intravenous drug users are the second largest group to develop the acquired immunodeficiency syndrome, and they are the primary source for heterosexual and perinatal transmission in the United States and Europe. Understanding long-term trends in the spread of human immunodeficiency virus among intravenous drug users is critical to controlling the acquired immunodeficiency syndrome epidemic. Acquired immunodeficiency syndrome surveillance data and seroprevalence studies of drug treatment program entrants are used to trace seroprevalence trends among intravenous drug users in the borough of Manhattan. The virus entered this drug-using group during the mid-1970s and spread rapidly in 1979 through 1983. From 1984 through 1987, the seroprevalence rate stabilized between 55% and 60%--well below hepatitis B seroprevalence rates. This relatively constant rate is attributed to new infections, new seronegative persons beginning drug injection, seropositive persons leaving drug injection, and increasing conscious risk reduction.     

海口市吸毒人群TT病毒感染情况的调查

目的：了解TT病毒在吸毒人群中的感染情况和传播途径。方法：对海口市公安局戒毒所收容的221例吸毒进行不同因素分析，采用巢式PCR法检测血清中的TTV DNA，同时检测血清中的甲型肝炎病毒（HAV）、庚型肝炎病毒（HGV）、艾滋病（HIV）和梅毒。结果：211例吸毒血清中TTV DNA阳性检出率为31．6％（70／221），HAV、HBV、HCV、HEV、HGV、HIV和梅毒阳性检出率分别为0．4％（1／221）、45．7％（101／221）、11．8％（26／221）、2．2％（5／221）、10．4％（23／221）、0（0／221）、5．9％（13／221）。结论：吸毒人群是TT病毒感染的高危人群；静脉注射毒品、有非固定婚外性伴侣等因素与TT病毒感染密切相关；TT病毒与甲－庚型肝炎病毒的存在合并感染，其中乙型及丙型肝炎重叠TT病毒感染较常见。另外，我们在1例HAV阳性的血清中也检出TTV DNA，提示TT病毒除存在血液传播途径外，还可能存在非血源性的感染传播途径。