南宁市102例HIV/HCV共感染者HCV基因型特征分析

目的了解南宁市静脉注射吸毒人群(IDUs)中HIV/HCV共感染者HCV基因亚型流行情况。方法收集2012—2014年间南宁市静脉注射吸毒人员HIV/HCV共感染者血浆样本总共108份,设计特异性引物,通过巢式PCR对HCV NS5B区域长339 bp的片段进行扩增并测序,构建系统进化树对HCV进行基因分型。结果 108份血浆样本中巢式PCR成功扩增基因片段102份,系统进化分析显示检出4种HCV基因型含6种基因亚型,各基因亚型所占样本比例为6a 34.31%(35/102)、3b 33.33%(34/102)、1a 20.59%(21/102)、1b 6.87%(7/102)、3a 3.92%(4/102)和2a 0.98%(1/102)。在不同人口学特征时102份样本HCV基因型组成差异无统计学意义(P0.05)。结论南宁市IDUs人群HIV/HCV共感染者中至少存在6种HCV基因亚型流行,6a、3b和1a为主要流行亚型。     

昆明市区吸毒人群HIV感染情况分析

目的:了解昆明市成年吸毒人群HIV感染情况及原因,为昆明市下一步针对吸毒人群制定HIV防治及干预措施提供方法和依据。方法:对昆明市疾病预防控制中心美沙酮健康门诊就诊的1 702例吸毒人员进行HIV初筛,确认试验,并对感染者年龄、性别、学历、婚姻、职业等情况进行统计分析。结果:1 702例吸毒人员中感染HIV者325人,感染率为19.1%;男性感染者212例,感染率为12.5%,女性感染者113人,感染率为6.6%;吸毒人群大多学历普遍较低,基本为初中以下学历,占76.6%;大部分为未婚或者离异人群,占65.5%;感染者多为中年人,占92.3%;而且多是无业人员,占79.7%。结论:加强对吸毒人群HIV宣传及干预工作;扩大及规范我市健康清洁针具交换工作,减少共用注射器静脉吸毒;加大毒品危害宣传力度及禁毒工作,减少新发吸毒人员产生;加大政府投入,对吸毒者进行职业培训,增加吸毒人员就业机会。     

Prevalence of Mycobacterium tuberculosis infection among injection drug users in Toronto

BACKGROUND: Injection drug users are at increased risk of Mycobacterium tuberculosis infection and active tuberculosis (TB). The primary objective of this study was to determine the prevalence of M. tuberculosis infection among injection drug users in Toronto, as indicated by a positive tuberculin skin test result. An additional objective was to identify predictors of a positive skin test result in this population. METHODS: A cross-sectional study was carried out involving self-selected injection drug users in the city of Toronto. A total of 171 participants were recruited through a downtown Toronto needle-exchange program from June 1 to Oct. 31, 1996. RESULTS: Of 167 subjects tested, 155 (92.8%) returned for interpretation of their skin test result within the designated timeframe (48 to 72 hours). Using a 5-mm cut-off, the prevalence rate of positive tuberculin skin test results was 31.0% (95% confidence interval 23.8% to 38.9%). Birth outside of Canada and increasing age were both predictive of a positive result. INTERPRETATION: There is a high burden of M. tuberculosis infection in this population of injection drug users. The compliance observed with returning for interpretation of skin test results indicates that successful TB screening is possible among injection drug users.     

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We reviewed 92 published and unpublished studies of the prevalence of infection with the human immunodeficiency virus (HIV) among intravenous drug users (IVDUs) in the United States.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.     

江苏昆山市吸毒人群HIV和HCV感染情况及相关行为研究

目的了解昆山市吸毒人群HIV和HCV感染状况及其相关行为。方法2010年2月,对美沙酮维持治疗门诊的215名吸毒人员进行HIV和HCV抗体检测,并对其采用面对面访问,了解其相关高危行为。结果检出HIV抗体阳性1例,感染率0．47％;HCV抗体阳性148例,感染率为68。84％。采用静脉吸毒167例,占77．67％。共用针具37例,占17．21％。过去3个月发生性行为的人数为145例,性行为发生率为67．44％;最后一次性行为使用安全套者25人,安全套使用率为11．63％。结论昆山市吸毒人群HIV感染属低流行,HCV感染属于高流行,而且流行的危险因素隐患大,特别警惕HIV、HCV从吸毒者向暗娼或嫖客到家庭成员传播。需进一步加强综合性干预措施。     

吸毒人群HIV阳性者高危行为状况分析

目的了解静脉吸毒人群HIV感染者高危险行为现状，为更好管理和开展宣传干预HIV感染者提供科学依据。方法采用滚雪球抽样方法，对南宁市社区379例吸毒人群进行问卷调查及HIV抗体检测，分析静脉吸毒人群HIV感染者高危行为情况。结果静脉吸毒人群HIV感染率为22．2％，男高于女。HIV感染者最近6个月共针率为65．5％，与配偶或同居者、临时性伴、商业性伴发生性行为安全套使用率分别为15．1％、17．2％、15．0％，出现相关性病症状23．8％。结论吸毒人群中普遍存在高危行为，应加强对吸毒人群的监测、宣传教育和行为干预，通过干预平台来预防和控制艾滋病。     

保山市2011年吸毒人群HIV哨点监测结果分析

目的 通过分析2011年保山市吸毒人群艾滋病病毒(HIV)哨点监测资料,以了解HIV,梅毒(SP),丙型肝炎(HCV)在该人群中的流行现状以及相关的危险行为特征.方法 使用SPSS15.0统计软件对2011年保山市吸毒人群HIV哨点监测数据进行统计分析.结果 吸毒人群,HIV阳性率为3.5％,SP阳性率为2.1％,HCV阳性率为44.8％;主要使用的毒品海洛因,占84.9％.注射毒品者占41.9％,其中共用针具者占18.8％.最近一年发生商业性行为者占21.6％,其中从未使用安全套者占25.6％,有时使用占者27.2％,每次都是使用者占47.2％.结论 HIV、SP、HCV不同程度的在保山市吸毒人群中流行.注射毒品,无保护性性行为是上述三种疾病传播的主要因素,因此在吸毒人群加强清洁针具交换和推广安全套使用有利于控制这些疾病的蔓延.     

美国静脉注射吸毒者的HCV负载及存活率

慢性丙型肝炎病毒（HCV）感染，有时可同时感染HIV和人T淋巴细胞病毒Ⅱ型（HTLV—Ⅱ），其发展为终末期肝病（ESLD）的风险性很高。作在1987—1991年间，对美国9个城市的6750例静脉注射吸毒中伴或不伴有HIV／HTLV—Ⅱ协同感染的HCV患，评估ESLD死亡是否与发病前的HCV—RNA水平或特异性HCV蛋白抗体有关。作对比了84例ESLD后代和305例随机选择的可检测出HCV—RNA的参加，根据性别、种族、HIV和HTLV—Ⅱ分层。ESLD死亡的相对风险度（RH）可从比例风险模型中获到。分别或联合考虑，ESLD死亡风险与抗HCV c-22（P）、c-33（P）、c-100（P）及NS5蛋白的抗体浓度无关，但是它会随着HCV—RNA水平的增加而增加（校正后每log10U／ml为RH2．26，95％CI 1．45～5．92）。在校正乙醇消耗后，HCV—RNA水平和ESLD死亡的关系仍是显的（校正后每log10U／ml为RH2．57，95％CI1．50～8．10）。因AIDS死亡（n=45）和其他原因发生的死亡（n=43）与HCV—RNA无关（各自校正后每log10U／ml的RH分别为1．14和1．29）。校正HCV—RNA后，多变量分析显示HIV感染和ESLD风险无关。     

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.     

Unexplained deaths among injection drug users: a case of probable Clostridium myonecrosis

A series of unexplained deaths associated with soft-tissue inflammation and severe systemic sepsis was reported among injection drug users (IDUs) in the United Kingdom and the Republic of Ireland in 2000. Health Canada has identified one reported fatality in an IDU that matched the case definition. Although the cause of the epidemic in the UK and Ireland is not fully understood, contributing factors include injecting into muscle or beneath the skin, rather than directly into a vein, and the use of acid to dissolve the heroin. This single Canadian case is considered to be a sporadic event that occurs at a low background rate among IDUs. These cases serve to remind primary health care providers to be vigilant in cases of soft-tissue infection among IDUs and not to underestimate the potential severity of the situation.     

惠州市惠阳区吸毒人员和一般住院人群HIV感染调查

目的 了解本地区吸毒人员、住院人群HIV感染水平,为艾滋病预防控制工作提供依据。方法对2008-2009年的监测资料、发放的调查表进行综合分析。结果2008～2009年吸毒人员HIV感染率分别为1．52％（9／592）、1．65％（8／486）;住院人群HIV感染率分别0．071％（6／8511）、0．099％（2／2 013）;结论本地区HIV感染者主要发生在吸毒人员等高危人群,一般住院人群HIV感染率较低,应加强对吸毒人员等高危人群的健康宣教和行为干预,防止HIV从该人群向一般人群扩散。