中国内地大、中学生中男男性行为者HIV感染率的Meta分析

目的运用Meta分析综合评价2005-2010年中国内地大、中学生中男男性行为者HIV感染率,并分析其在样本量、抽样方法及不同研究时间等因素间的差别。方法检索万方数据库、维普信息资源系统、中国期刊全文数据库、中国生物医学文献数据库及PubMed数据库,收集所有关于中国内地大中学生中HIV感染状况的调查研究,再从中筛选出有关男男性行为者群体的研究报告。对各项研究进行异质性检验,以确定采用固定模型或随机模型进行合并分析,绘制漏斗图进行发表偏倚的评估。结果共入选相关研究10项,累计大、中学生MSM人数为2014人,HIV感染人数为106人,总的HIV感染率为4.6%(95%CI 2.9%～6.3%)。将HIV感染率按照样本量、抽样方法及研究时间等进行分层分析,样本量大于200时合并的HIV感染率为4.7%(95%CI 2.5%～7.0%),样本量小于等于200时合并的HIV感染率为4.7%(95%CI 1.9%～7.4%);抽样方法为滚雪球时,合并HIV感染率为6.1%(95%CI 3.0%～9.1%),高于非滚雪球抽样的方法 2.9%(95%CI 1.7%～4.1%);2007年及以前研究合并的HIV感染率为3.0%(95%CI 1.7%～4.2%),低于2008年及以后的研究6.0%(95%CI 3.1%～9.0%)。结论中国内地大、中学生中男男性行为者HIV感染率远高于一般人群。     

钦州市吸毒人群性传播疾病感染状况及HIV感染影响因素分析

目的了解钦州市吸毒人群人类免疫缺陷病毒(HIV)、丙型肝炎病毒(HCV)和梅毒(TP)的感染状况,探讨HIV感染的影响因素,为制定疾病防控策略提供科学依据。方法选取2014年4月～2016年7月在钦州市辖区内活动的吸毒人员作为研究对象,通过问卷调查收集相关信息,并采集5.0 mL静脉血进行HIV、HCV及梅毒抗体检测。结果 3 148例研究对象中,男女性别比为37.9:1;平均(32.66±7.59)岁;HIV、HCV和梅毒感染率分别为4.7%、59.5%和3.6%;女性HCV和梅毒感染率高于男性(P0.05),采用注射方式吸毒者HIV和HCV感染率则明显高于非注射方式吸毒者(P0.05);多因素Logistic回归分析结果显示,年龄≥41岁(OR=9.50, 95%CI:1.25～72.38)、离异或丧偶(OR=1.83, 95%CI:1.06～3.17)、曾经共用针具(OR=2.95, 95%CI:2.06～4.22)和感染HCV(OR=6.43, 95%CI:3.32～12.46)是吸毒人群感染HIV的危险因素;在婚(OR=0.64, 95%CI:0.42～0.97)和知晓艾滋病相关知识(OR=0.55 95%CI:0.34～0.87)是吸毒人群感染HIV的保护因素。结论钦州市吸毒人群HIV、HCV和梅毒的感染率较高,感染HIV的影响因素较多,应针对各个因素制定综合干预措施,控制相关疾病的传播蔓延。     

云南省德宏州2017年婚检人群HIV感染率及影响因素分析

  目的  了解2017年德宏州进行婚前医学检查人群中的（human immunodeficiency virus，HIV）感染状况并分析其影响因素。  方法  整理2017年德宏州的婚检人群数据，描述分析其人口学特征，并使用单因素和多因素Logistic回归分析相应的影响因素。  结果  2017年德宏州共有21 875例婚检者参与HIV检测，有98人确证为HIV抗体阳性，HIV感染率为0.45%，男性感染率为0.47%（52/10 955），女性感染率为0.42%（46/10 920）。98例感染者中有20名感染者为首次新报告阳性，感染途径以性传播感染为主，占81.63%（80/98）。Logistic多因素回归分析显示:年龄、民族、是否吸毒是婚检人群HIV感染的影响因素。相对于25岁以下人群，31~、41~岁年龄组人群HIV感染危险性增加（OR=3.78，95%CI:1.81~7.89，P<0.001；OR=3.95，95%CI:1.72~9.08，P=0.001）；傣族、景颇族的HIV感染危险性高于汉族（OR=1.86，95%CI:1.06~3.29，P=0.031；OR=3.25，95%CI:1.81~5.84，P<0.001）。吸毒人群的HIV感染危险性远高于不吸毒人群（OR=926.76，95%CI:271.65~3161.71，P<0.001）。  结论  年龄、民族、是否吸毒为婚检人群HIV感染的影响因素，需要对危险因素采取针对性措施。HIV感染途径以性传播感染为主，通过婚检可以有效发现并控制HIV传播。     

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。     

2020—2021年镇江市吸毒人群高危行为及HIV、TP、HCV感染情况

目的 了解镇江市吸毒人群高危行为以及人类免疫缺陷病毒（human immunodeficiency virus,HIV）、梅毒螺旋体（treponema pallidum,TP）、丙型肝炎病毒（hepatitis c virus,HCV）的感染状况,为开展吸毒人群的干预提供依据。方法 采用分层抽样于2020年1月—2021年12月由强制戒毒所管理人员中抽取858人,其中愿意参加调查的805人,在告知检测知情同意后,收集人口学和高危行为信息,并采集静脉血进行HIV、TP、HCV检测。结果 共调查805人,回收有效问卷785份,应答率为97.52%。新型毒品、传统毒品使用率分别为82.0%和18.0%。HIV、TP、HCV感染率分别为2.3%、13.0%、7.7%。多因素logistic回归分析表明学生或无业（OR=3.836,95%CI:2.044～7.497）、收入>6 000元/月（OR=2.856,95%CI:1.316～6.469）人群更倾向使用新型毒品;使用新型毒品TP感染率较高（OR=3.477,95%CI:1.239～12.840）,而传统毒品使用者HIV(OR=0....     

广西部分吸毒人群丙型肝炎病毒及艾滋病病毒感染情况调查分析

目的了解我区吸毒人群中丙型肝炎病毒（HCV）及艾滋病病毒（HIV）感染和两者合并感染的情况,为制定艾滋病及丙型肝炎的防治措施提供理论依据。方法对我区部分在押的吸毒者共计3 000名作为调查对象,制定统一的调查问卷进行调查,并采集静脉血,分离血清,用酶联免疫吸附试验（ELISA）夹心法检测HCV抗体和HIV抗体,当HIV抗体阳性时则用蛋白免疫印迹试验（Western Blotting,WB）进行HIV抗体确证实验。结果在3 000名吸毒患者中,男性占88.4%,女性占11.6%;总的HCV抗体阳性率是85.6%,HIV抗体阳性率是18.2%,其中静脉注射吸毒者（IDUs）HCV抗体阳性2 553名,感染率为86.1%,口吸吸毒者HCV抗体阳性21名,感染率60.0%;口吸吸毒人群中HIV抗体阳性3名,感染率为8.56%,静脉吸毒人群中HIV抗体阳性543名,感染率18.31%;HCV抗体阳性合并HIV抗体阳性有537名,感染率为20.86%。结论广西吸毒人群的HCV感染率较高,尤其是静脉注射吸毒人群,应当加强对吸毒人群的综合干预措施,控制HCV及HIV的传播,降低新发感染。     

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。     

德宏州HIV单阳夫妻双方丙型肝炎病毒感染状况及影响因素

目的 了解云南省德宏州人类免疫缺陷病毒（human immunodeficiency virus,HIV）单阳夫妻双方（HIV感染者及其阴性配偶）丙型肝炎病毒（viral hepatitis C,HCV）感染情况及其影响因素。方法 收集HIV单阳夫妻的人口学特征、行为学指标和血样,并进行HCV抗体检测,应用χ2检验和Logistic回归分析不同因素对HCV感染率的影响。结果 582对HIV单阳家庭中,夫妻双方均感染HCV有12对（2.1%）,仅一方感染HCV有138对（23.7%）。HIV阳性配偶HCV感染率为23.2%,HIV阴性配偶HCV感染率为4.6%,差异有统计学意义（χ2=83.641,P<0.001）。男性配偶中,HIV阳性者HCV感染率为32.6%,HIV阴性者HCV感染率为4.6%,差异有统计学意义（χ2=56.828,P<0.001）;女性配偶中,HIV阳性者HCV感染率为4.6%,HIV阴性者HCV感染率为4.7%,二者无统计学差异（χ2<0.001,P=0.958）。多因素Logistic回归分析显示,男性配偶中35~46岁、景颇族、HIV阳性、吸毒是HCV感染的危险因素。结论 德宏州HIV单阳夫妻特别是HIV阳性男性配偶中HCV感染率高,HCV存在性传播的潜在威胁,有必要加强对HIV单阳家庭的丙型肝炎防治,对男性和女性配偶采取针对性的预防干预措施。     

中山市2004-2009年吸毒人群哨点监测结果分析

目的探索中山市注射吸毒人群（injection drug users,IDUs）艾滋病病毒（human immunodeficiency virus,HIV）感染率、流行趋势及相关因素。方法 2004-2009年,按照国家哨点监测方案的要求,对新进入中山市戒毒所的吸毒者进行问卷调查和血清学检测;采用SPSS 16.0软件进行数据分析。结果 2004-2009年,进入哨点监测的IDUs HIV阳性率呈波浪状,波动于4.3%～11.4%;本地户籍、广西户籍及其他户籍的IDUs HIV阳性率分别为0.6%～4.4%、9.8%～31.4%及0～9.1%;多因素Logistic回归模型提示,针具共用是不同户籍IDUs HIV感染的危险因素。结论吸毒人群哨点监测数据分析中,应关注监测人群的户籍来源,尤其是广西户籍的构成比;在下一步的健康教育和行为干预中,对来自吸毒严重地区,尤其是广西户籍的吸毒者应给予更多关注。     

中缅静脉吸毒人员HIV、HCV、梅毒感染情况及其影响因素对比分析

目的对比分析中缅静脉吸毒人员(IDUs)HIV、HCV、梅毒感染情况及其影响因素,为下一阶段干预提供科学依据。方法 2013年1月至3月,采用滚雪球抽样方法调查镇康县中缅社区静脉吸毒人员,问卷收集人口学资料、高危行为,同时进行HIV/HCV/梅毒血清学检验。DpiData3.1建立数据库,SPSS17.0进行统计分析。结果共调查241名IDUs,其中缅甸154人,中国87人。均以未婚中青年男性为主,缅甸IDU人员HIV/HCV/梅毒阳性率分别为13.6%、29.8%、2.5%;中国IDU人员HIV/HCV/梅毒阳性率分别为12.6、44.8%、0.0%。中缅静脉吸毒人员HCV感染率差异有统计学意义(P0.05),中缅IDUs最近一次使用安全套情况与三个感染呈负相关关系(OR值分别为-2.288,-0.419,);中国IDUs最近是否发生付费性行为与三个感染呈正相关关系(OR值为0.387)结论边境双侧中缅静脉吸毒人员HIV、HCV感染率均较高,安全套使用能有效降低相关感染率,嫖娼影响中国IDU的HIV/HCV/梅毒感染率。     

HIV, hepatitis C, and hepatitis B infections and associated risk behavior in injection drug users, Kabul, Afghanistan

Limited prevalence data for HIV, hepatitis B surface antigen (HBsAg), and hepatitis C virus (HCV) exist for Afghanistan. We studied a cross-sectional sample of adult injection drug users (IDUs) in Kabul, Afghanistan, from June 2005 through June 2006. Study participants completed interviewer-administered questionnaires and underwent testing for HIV, antibody to HCV, and HBsAg. Overall prevalences of HIV, HCV, and HBsAg were 3.0% (95% confidence interval [CI] 1.7%-5.1%), 36.6% (95% CI 32.2%-41.0%), and 6.5% (95% CI 4.2%-8.7%), respectively (N = 464). Among male IDUs (n = 463), risky behavior, including sharing syringes (50.4%), paying women for sex (76.2%), and having sex with men or boys (28.3%), were common. Needle sharing, injecting for > or = 3 years, and receiving injections from nonmedical providers were independently associated with increased risk for HCV infection. The high prevalence of risky behavior indicate that Kabul is at risk for an HIV epidemic. Scale-up of harm-reducing interventions is urgently needed.     

Self-reported hepatitis B and C virus infections had low sensitivity among HIV-infected patients

OBJECTIVE: To determine the validity of self-reported hepatitis B virus (HBV) and hepatitis C virus (HCV) in HIV-infected injection drug users (IDUs) vs. nonIDUs. METHODS: A cross-sectional study was performed among HIV-infected IDUs and nonIDUs in the Penn Center for AIDS Research (CFAR) Database. Self-reported past HBV, HCV, and serostatus were obtained from the CFAR Database. RESULTS: Among 970 subjects (798 nonIDUs; 172 IDUs), there was no difference in sensitivity of self-reported HBV between nonIDUs (27% [95/346]; 95% CI, 23%-32%) and IDUs (26% [31/117]; 95% CI, 19%-35%; P>0.5), but specificity was greater among nonIDUs (96% [360/374; 95% CI, 94%-98%] vs. 78% [28/36; 95% CI, 61%-90%]; P<0.001). Sensitivity of self-reported HCV was greater among IDUs (78% [101/130; 95% CI, 70%-85%] vs. 62% [47/76; 95% CI, 50%-73%]; P=0.02), but there was no difference in specificity (97% [626/643]; 95% CI, 96%-98% for nonIDUs vs. 93% [26/28]; 95% CI, 76%-99%] for IDUs; P=0.2). CONCLUSIONS: The sensitivity of self-reported HBV and HCV compared to actual serostatus are not sufficiently high enough to warrant their use to estimate the prevalence and incidence of these infections.     

河南省吸毒人群HIV/HCV感染状况分析

目的 了解河南省吸毒人群人类免疫缺陷病毒(HIV)、丙型肝炎病毒(HCV)感染状况及其相关危险因素,为针对其制订艾滋病防治措施提供科学依据.方法 于2009年1月-2010年6月对河南省美沙酮维持治疗门诊收治的836名吸毒者进行行为学和血清学调查,分析其HIV、HCV感染的危险因素.结果 836名吸毒者HIV抗体阳性者12例,阳性率为1.44％,HCV抗体阳性者32例,阳性率为3.83％;HIV/HCV合并感染率为0.8％ (7/836);近半年吸毒方式为单纯注射的人群合并感染率为12.1％ (7/58);曾共用针具人群的合并感染率为9.5％(2/21);20.5％(171/836)的吸毒者曾注射过毒品;66.7％(565/836)的吸毒者曾戒毒,但均未成功;在进入美沙酮门诊时59.7％(499/836)的研究对象尿检阳性,提示近期曾使用毒品.结论 吸毒人群是HIV、HCV感染的易感人群,同时其存在多种导致HIV传播的危险因素;应加强美沙酮维持治疗,降低吸毒人群高危行为,遏制艾滋病在该人群中的传播.     

Low incidences of human immunodeficiency virus and hepatitis C virus infection and declining risk behaviors in a cohort of injection drug users in Chennai, India

The authors characterized human immunodeficiency virus (HIV) and hepatitis C virus (HCV) incidence and prospective changes in self-reported risk behavior over 2 years among 1,158 injection drug users (IDUs) recruited in Chennai, India, in 2005-2006. At baseline, HIV prevalence was 25.3%, and HCV prevalence was 54.5%. Seropositive persons with prevalent HIV infection were used to estimate baseline HIV incidence by means of the Calypte HIV-1 BED Incidence EIA (Calypte Biomedical Corporation, Portland, Oregon). Longitudinal HIV and HCV incidence were measured among 865 HIV-negative IDUs and 519 HCV antibody-negative IDUs followed semiannually for 2 years. Participants received pre- and posttest risk reduction counseling at each visit. Estimated HIV incidence at baseline was 2.95 per 100 person-years (95% confidence interval (CI): 1.21, 4.69) by BED assay; observed HIV incidence over 1,262 person-years was 0.48 per 100 person-years (95% CI: 0.17, 1.03). HCV incidence over 645 person-years was 1.71 per 100 person-years (95% CI: 0.85, 3.03). Self-reported risk behaviors declined significantly over time, from 100% of participants reporting drug injection at baseline to 11% at 24 months. In this cohort with high HIV and HCV prevalence at enrollment, the authors observed low incidence and declining self-reported risk behavior over time. While no formal intervention was administered, these findings highlight the potential impact of voluntary counseling and testing in a high-risk cohort.     

Prevalence and risk factors of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus infections among drug addicts in Bangladesh

This cross-sectional study investigated the prevalence and risk factors of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections among 266 drug users attending a drug-addiction treatment centre in Dhaka, Bangladesh, from November 1996 to April 1997. Of the 266 addicts, 129 were injectable drug users (IDUs), and 137 were non-injectable drug users (non-IDUs). The seroprevalences of hepatitis B virus surface antigen (HBsAg), anti-HBc, anti-HBs, and anti-HCV antibodies among the IDUs were 8 (6.2%), 41 (31.8%), 15 (11.6%), and 32 (24.8%), and among the non-IDUs were 6 (4.4%), 33 (24.1%), 9 (6.6%), and 8 (5.8%) respectively. None of the drug users were positive for anti-HIV antibody. Although the prevalence of HBV infection did not significantly differ between the IDUs and the non-IDUs, the prevalence of HCV infection was significantly higher among the IDUs. Among the IDUs, the prevalence of both HBV and HCV infections was associated with sharing of needles and longer duration of injectable drugs used. The seroprevalence of HBV infection in both IDUs and non-IDUs was significantly higher among those who had a history of extramarital and premarital sex. The prevalence of HCV infection was not associated with sexual promiscuity. There was no association between the seroprevalence of HBV and HCV infections and age. Active preventive programmes focusing on educational campaigns among the youths against substance abuse should be undertaken.     

Incidence and risk factors of HCV and HIV infections in a cohort of intravenous drug users in the North and East of France

In order to evaluate the incidence and risk factors of infection by hepatitis C virus (HCV) among injecting drug users (IDUs), we conducted a prospective cohort study of HCV- and human immunodeficiency virus (HIV)-negative IDUs in the North and East of France. A total of 231 HCV and HIV IDUs who had injected drugs at least once in their lifetime were followed up every 3 months over a 12-month period. Serum anti-HCV and anti-HIV were tested at inclusion in the study and at the end of the follow-up. Data on injecting practices were collected at inclusion and at each visit. Of the 231 participants included, 165 (71.4%) underwent a final HCV and HIV serum test. The incidence was nil for HIV infection and 9/100 person-years (95% CI 4.6-13.4) for HCV infection. In a multivariable analysis, we found that syringe and cotton sharing were the only independent predictive factors of HCV seroconversion.     

Association between heroin use, needle sharing and tattoos received in prison with hepatitis B and C positivity among street-recruited injecting drug users in New Mexico, USA.

This study aimed to assess the seroprevalence and risk factors for hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV-1 infections among injecting drug users (IDU) in New Mexico. Serological and behavioural surveys were conducted in conjunction with street-based outreach, education and HIV counselling and testing. High rates of antibody positivity for HCV (82.2%) and HBV (61.1%), and a low rate for HIV (0.5%) were found. In multivariate analyses, both HBV and HCV infection were positively associated with increasing age, increasing years of injection and heroin use. Receipt of a tattoo in prison/jail was associated with HBV (odds ratio = 2.3, 95% confidence interval 1.4, 3.8) and HCV (OR = 3.4, 95% CI = 1.6, 7.5) infections. Prevention of bloodborne pathogens among IDUs should focus on young users, early in their drug use experience. Studies examining the relationship between tattooing and HBV and HCV infection are needed as are efforts to promote sterile tattooing, in prisons and elsewhere.     

Hepatitis B and hepatitis C seroprevalence and risk behaviour among community-recruited drug injectors in North West Wales

We estimated the prevalence of markers of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection, and injecting risk behaviour, among community-recruited injecting drug users (IDUs) in North West Wales in 2001 and 2002. Sample collection was undertaken by trained current and former IDUs. Oral fluid samples (n = 153) were tested as part of the Unlinked Anonymous Prevalence Monitoring Programme ongoing survey of IDUs. Approximately 12% of the sample reported that they were currently in a drug treatment programme. Of the 153 samples screened 27% (95% CI 20%-34%, 41/153) were anti-HBc positive, and 23% (95% CI 16%-30%, 35/153) were anti-HCV positive. Sixteen per cent (95% CI 10%-22%, 25/ 153) of the samples were positive for both anti-HBc and anti-HCV. Of the subjects 15% (95% CI 9%-20%) knew they had been vaccinated against hepatitis B. Direct sharing of needles and syringes in the 28 days prior to interview was reported by 44% (95% CI 35%-54%), and sharing of any equipment including that used for drug preparation prior to injection was reported by 66% (95% CI 57%-76%). In North West Wales, syringe sharing is a common practice, and a high proportion of IDUs have been exposed to bloodborne viruses. Hepatitis B vaccination coverage within this population appears to be low and needs to be increased. Further efforts are needed to improve the availability of clean injecting equipment.     

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.     

The multiperson use of non-syringe injection equipment and risk of hepatitis c infection in a cohort of young adult injection drug users, chicago 1997-1999

PURPOSE: The possibility that hepatitis C virus (HCV) is transmitted via the multiperson use of injection paraphernalia other than syringes has been suggested, but epidemiologic studies to examine the association are difficult to design due to saturation levels of infection in most samples of injection drug users (IDUs). This study (1) assembled a sample of young adult IDUs, among whom hepatitis C infection prevalence was still moderate, (2) measured incident HCV infection, and (3) determined the risk for seroconversion associated with specific forms of sharing injection paraphernalia.METHODS: Between 1997 and 1999, 702 IDUs, 18-30 years old, were interviewed and screened for antibodies to HCV at baseline and at 6 and 12 months post-baseline. Participants were recruited through street outreach, advertising and chain-referral from ethnically diverse neighborhoods in metropolitan Chicago. Data were analyzed using standard survival statistical methods.RESULTS: HCV prevalence was 27% at enrollment. During 296.5 person-years of observation, we observed 37 HCV seroconversions (incidence: 12.5/100 person-years). The adjusted relative hazard (RH) of seroconversion, after controlling for demographic and drug use covariates, was highest for sharing cookers (RH, 3.58; 95% CI 1.47-8.70), followed by sharing rinse water (RH, 2.16; 95% CI 1.03-4.52), and cottons (RH, 1.84; 95% CI 0.95-3.56). Risk associated with syringe sharing was marginally significant, and backloading was unassociated with hepatitis C seroconversion. Adjusting for syringe sharing, the independent effects of sharing cookers and cottons remained significant, and a final model that included each sharing practice demonstrated that sharing cookers had at the strongest association with seroconversion (RH, 3.03; 95% CI 1.05-8.72).CONCLUSIONS: This study suggests that sharing non-syringe paraphernalia may be an important cause of hepatitis C virus transmission between IDUs.