吸毒人群中丙型肝炎患者F蛋白抗体检测

目的了解丙型肝炎病毒（HCV）F抗体在南京市吸毒人群HCV感染者中的分布特点,为丙型肝炎防治及制定慢性化预防策略提供依据。方法利用pEGX-4T-2/HCV-F融合载体表达蛋白HCV-F/GST作为抗原,包被酶联反应板,ELISA间接法检测362例HCV感染者及50例正常人血清HCV-F抗体,结合其人口学特征和疾病特征,统计分析HCV-F抗体的分布情况及与HCV感染的关系。结果 362例感染HCV的吸毒者F抗体阳性率为31.5%。通过比较发现F抗体阳性率在性别、吸毒时间、吸毒方式等因素中分布无统计学差异,而F抗体阳性率与年龄、联合感染可能具有一定关联。结论南京市吸毒人群HCV感染者中存在F抗体,其可能与疾病病程相关。     

Exploring the contingent reality of biomedicine: Injecting drug users,hepatitis C virus and risk1

Hepatitis C is an emerging theme of contemporary public health discourses related to illicit drug injection practices. Such discourses differentiate injecting from non-injecting users in an actuarial risk logic, targeting drug-injecting users as a population in need of support in the management of risks attributed to their practices. Public health strategies suppose, among other things, that injecting drug users adopt a homogeneous vision of hepatitis C, and of its risk, that is compatible with the reality produced by biomedicine. The majority of studies conducted on hepatitis-related risks in the context of harm reduction strategies are interested in socio-demographic factors to understand the behavioural variations within this targeted population. The meaning given to the virus and to its risk has remained marginal and the diversity of areas of construction of meaning tends to be ignored in the academic literature. Attention to this diversity indicates a complex tissue of social and communicational relations and the contingency of the symbolic instruments that people manipulate in their relation with their body and towards others; a complex tissue in which the reality of biomedicine is one among many alternative realities.     

云南省西双版纳自治州景洪市吸毒人群HCV感染情况及其危险因素

目的 分析吸毒人群丙型肝炎病毒(HCV)的感染情况及其危险因素。方法 研究人员于2021年1—7月依据纳入排除标准招募云南省西双版纳自治州景洪市戒毒所、美沙酮门诊及社区的吸毒人员。采用结构化问卷调查形式,并抽取被调查者3 mL血清样本,使用酶联免疫吸附试验(ELISA)进行HCV血清学筛查测试。分析云南省西双版纳自治州景洪市吸毒人群HCV感染情况及其危险因素。结果 共调查404例吸毒人群,HCV抗体阳性26例,阳性率6.44%。静脉注射吸毒(OR=4.236,95%CI:1.644～10.913,P=0.003)、女性(OR=0.135,95%CI:0.019～0.987,P=0.048)、高中及以上文化程度(OR=6.745,95%CI:1.113～40.890,P=0.038)的吸毒人群HCV感染风险较高,差异均有统计学意义(均P<0.05)。结论 云南省西双版纳自治州景洪市吸毒人群中采用静脉注射吸毒方式是HCV感染的高危因素,同时吸毒者的年龄、文化程度、性别也与HCV感染有关。     

Drug trafficking routes and hepatitis B in injection drug users, Manipur, India

Prevalence of hepatitis B genotype C in injection drug users in the northeastern Indian state of Manipur, neighboring the "Golden Triangle," correlates well with overland drug-trafficking routes, the injection drug use epidemic, and the spread of HIV. Further spread to other regions of India through mobile populations is possible.     

Estimation of the number of injecting drug users attending an outreach syringe-exchange program and infection with human immunodeficiency virus (HIV) and hepatitis C virus: the AjUDE-Brasil project

This study estimated the number of street injecting drug user (IDU) clients of a syringe-exchange program (SEP) who were infected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV). A two-sample capture-recapture method was carried out. The first capture listed all interviewed IDUs outreached for syringe exchange from April 1 to May 1, 1998; the second capture involved those outreached from May 2 to June 6, 1998. Blood spots were collected for HIV and HCV serologies. Analysis used captured probability model varying with time. We interviewed 55 IDUs in the first capture and 99 in the second; 17 participated in both samples. An estimate of 317 IDUs attending the SEP was obtained (95% confidence interval [CI] 235–467). Based on the overall seroprevalence rates for HIV (47.7%) and HCV (53.1%), it was estimated that 151 IDUs were HIV infected (95% CI 112–223) and 168 (95% CI 125–248) were HCV infected. Enumeration of IDUs associated with estimates of the total number of HIV and HCV seropositives provide a powerful tool for SEPs to help monitor the number of IDUs, to plan for provisions, and to organize the new demands on existing health facilities for HIV and HCV care.     

An epidemic of hepatitis B virus infection among intravenous drug users in Iceland

This study describes an outbreak of hepatitis B primarily among intravenous drug users in Iceland which has a population with a very low incidence of hepatitis B virus infection. The incidence of acute hepatitis B is generally low in the Nordic Countries, in the order of one to five cases per 100,000 people per year. Between 1989 and 1992 there was an outbreak of hepatitis B virus infection primarily among the intravenous drug user (IVDU) population in Iceland. At the Department of Medical Virology, University of Iceland there were 44 cases of acute hepatitis B identified during the peak year 1990, an incidence of 16.9 cases of acute hepatitis B per 100,000 people. 63.6% of these were known to be IVDUs. The seroprevalence of the hepatitis B core antibody (anti-HBc) marker was assessed among 1100 randomly selected individuals. The average prevalence of this marker was 2.9% and rose from zero at the age of 15 and younger to 6.5% at the age of 65 and older. Among IVDUs attending a detoxification clinic in 1990 the prevalence of the anti-HBc was 32%. In contrast, those attending the same clinic, due to alcoholism only, did not have a significantly higher prevalence of anti-HBc than the group used for comparison.     

广西吸毒人群艾滋病病毒感染率调查

目的 了解广西百色地区吸毒人群中ＨＩＶ感染的流行情况及ＨＩＶ感染有关的危险因素。方法 对上述地区３２５名吸毒人员进行调查和血清ＨＩＶ抗体检测。结果 共检出ＨＩＶ感染者１１６例,ＨＩＶ感染率为３５．７％。与ＨＩＶ感染有关的危险因素主要是静脉注射吸瘃共用注射器,有静注毒品史者ＨＩＶ感染率为４０．９％,无静注史者为４．３％,广西吸毒人群中共用注射器现象十分严重,占７６．７％。结论 广西吸毒人群ＨＩＶ感染     

浙江省2011年新型毒品使用者艾滋病、梅毒和丙型肝炎感染状况及其危险行为特征分析

目的 了解浙江省新型毒品使用者艾滋病、梅毒和丙型肝炎(丙肝)感染水平、相关行为特征以及相互关系。方法 2011年在浙江省6个城市对戒毒人员进行匿名问卷调查,调查内容包括社会人口学、使用毒品种类、性行为、接受干预情况,并采集血液进行艾滋病、梅毒和丙肝抗体检测。利用SPSS 15.0统计软件进行数据分析。结果 共调查3 253人,其中新型毒品使用者1 298人,占39.9%,北部和中部地区、女性、≤25岁年龄组、浙江省户籍和有商业性性行为的吸毒者中使用新型毒品的比例较高。1 298例新型毒品使用者中,使用冰毒者占91.2%,HIV抗体阳性率为0.1%(95%CI:0.0%～0.2%),梅毒抗体阳性率为8.1%(95%CI:6.6%～9.6%),丙肝抗体阳性率为17.3%(95%CI:15.2%～19.4%);艾滋病知识知晓率为12.7%,有注射吸毒史者占9.2%,最近一年有商业性性行为者占29.6%。曾接受安全套发放和咨询的比例为33.4%,曾接受艾滋病检测的比例为14.0%。多因素分析表明,来自中部和南部地区的新型毒品使用者的梅毒感染、丙肝感染和有注射吸毒行为比例高于来自北部地区者;女性是梅毒感染的相关因素;曾注射吸毒和最近一年有商业性性行为与丙肝感染相互关联;曾注射吸毒行为与最近一年商业性性行为相互关联。男性、浙江省户籍及未接受过安全套发放和咨询者更有可能发生商业性性行为。结论 新型毒品使用者梅毒和丙肝感染水平高,不安全行为发生率高,接受干预服务比例低,提示需要提高对该人群的艾滋病、梅毒和丙肝感染风险的认识,设计制定针对该人群的有效干预措施,扩大干预覆盖率。     

Hepatitis C virus infection among short-term intravenous drug users in southern Taiwan

The purpose of this study was to determine the correlation between the prevalence of hepatitis C virus (HCV) infection with duration of drug use and other risk factors among drug users. This survey covered 899 male drug users from Kaohsiung Narcotic Abstention Institute and Kaohsiung prison. The prevalence of positive anti-HCV was 67.2% among intravenous drug users (IVDU) and 14.7% among non-intravenous drug users (non-IVDU). Among intravenous (IV) drug users, age and duration of drug use were independently related to HCV seropositivity. Seroprevalence rate for HCV in the IVDU group increased with increasing duration of injection use within the first seven years of drug use. However, the steepest trajectory in seroprevalence of HCV infection occurred within the first four months. Due to the high rate of HCV infection among drug users, investigation of risk behaviors should be routine in such a group. A high frequency of HCV infection was also found among short-term injectors, which indicated that early risk reduction intervention was an important measure in moderating HCV infection.     

吸毒人群中甲肝病毒感染及其影响因素

目的　了解吸毒人员中甲型肝炎病毒 (HAV)的感染状况及其影响因素 ,为防制甲肝提供科学依据。方法　采用现况研究 ,通过整群抽样 ,以问卷的方式收集吸毒人员有关资料并采集血标本。用酶联免疫吸附试验(ELISA法 ) ,检测血清中抗 -HAV。采用SPSS 10 0软件进行统计学分析。结果　 772名吸毒人员中检出阳性 5 14人 ,总感染率为 6 6 5 8% ;单因素分析 :不同地区 (χ2 =13 4 7,P <0 0 5 )、不同文化程度 (χ2 =7 36 ,P <0 0 5 )、不同婚姻状况 (χ2 =6 0 2 ,P <0 0 5 )甲肝病毒感染率有显著性差异。多因素分析 :吸毒人员中甲肝的感染与地区 ,文化程度 ,婚姻状况 ,与他人共用餐具等情况有关。结论　吸毒人群是甲型肝炎病毒感染的高危人群。甲型肝炎的影响因素有地区、文化程度、婚姻状况、与他人共用餐具等     

2008—2011年上海市普陀区社区吸毒人员吸毒行为及HIV、HCV、梅毒感染状况调查

目的了解上海市普陀区社区吸毒人群吸毒行为及HIV、HCV和梅毒感染情况。方法采用连续横断面调查方法对调查对象进行问卷调查和血样采集。结果 2008—2011年分别调查316、413、473和473例社区吸毒人员,该人群9种常见毒品均有使用,使用最多者为海洛因,分别占94.9%、93.7%、95.1%和96.8%,存在合并使用毒品的情况,分别有9.8%、6.1%、4.2%和7.6%使用两种及以上毒品,吸食冰毒比例逐年增加,分别占4.4%、4.6%、5.5%和5.9%;注射毒品者比例历年依次为64.2%、63.0%、57.5%和68.1%,注射吸毒者共用针具比例历年依次为12.9%、9.1%、10.3%和8.1%。HIV抗体血清学检测阳性率历年依次为0.0%、0.0%、0.0%和0.6%;HCV抗体阳性率分别为56.3%、60.3%、52.9%和60.0%;梅毒RPR阳性率分别为6.7%、6.3%、3.6%和8.0%。结论上海市社区吸毒人员使用毒品种类多,以海洛因为主,注射吸毒率、HCV和梅毒感染率较高,目前HIV仍处于低流行状态,但存在高感染风险。     

Hepatitis C infection in a cohort of injecting drug users

Objectives: To establish prevalence rates for hepatitis C antibodies in a cohort of injecting drug users and to study factors influencing positivity. To record current injecting practices. To identify the entry of hepatitis C into the cohort. To investigate the association between HCV positivity and PCR status.

Design: (i) Questionnaire covering demographic data, injecting behaviour, number of sexual partners, awareness of risk behaviour, awareness of serological status and subsequent behaviour change. (ii) Second questionnaire on recent drug use and injecting practices with a strong focus on frequency of sharing paraphernalia. (iii) PCR testing on HCV positive. (iv) Retrospective testing of subgroup to determine entry of hepatitis C into the cohort.

Setting: Recruitment in a large general practice in North West Edinburgh.

Participants: The main study group consisted of a large cohort (619) of past or present illegal drug injectors. The first, n=95, received the questionnaire (i). If they had injected in the past month they also completed the second questionnaire (n=26). PCR testing was carried out on a subset of the group of 95, selected because they had had a recent blood test (n=33). A random group of 20 of the main cohort of 619 who had hepatitis C antibody positive tests were selected for retrospective testing.

Main outcome measures: Prevalence of HCV antibodies, perceived and actual risk-taking behaviour. Antibody status of randomly selected early stored specimens. HCV PCR status.

Results: Positivity was associated with age, year of first use, sharing of injecting paraphernalia, year of most sharing, as well as length of use of injected drugs.

Awareness of HCV as a risk was found to be later than either HBV or HIV. No significant difference was found in numbers of sexual partners between those who were HCV positive and negative. Women and younger drug users were found to engage in more sharing of injecting paraphernalia, with women having more sharing partners. The entry of HCV into the cohort predated the early stored blood samples. No correlation was identified between length of drug use and PCR status.

Conclusions: HCV is acquired early in drug injecting careers. Whether or not this is changing is unclear but attempts to educate and support need to be directed towards younger drug users and women, who are at risk. Knowledge of risks from sharing injecting paraphernalia is poor. The impact of the hepatitis C epidemic is likely to continue to escalate with cases progressing to advanced clinical stages. PCR tests could be employed to select cases for referral or treatment. The harm reduction message needs to be clarified and re-emphasised.     

昆明市静脉注射吸毒人群丙型肝炎病毒基因型分析

目的 研究云南省昆明市静脉注射吸毒人群(IDUs)中丙型肝炎病毒(HCV)基因型的流行特点。方法 2014年4－7月在昆明市连续收集276份IDUs的血浆,其中199份样品为HCV抗体阳性,提取RNA后用巢式PCR对E1E2基因和NS5B基因的部分片段进行扩增。扩增产物经基因序列测定,所得序列通过构建系统进化树确定HCV的分子亚型。结果 结合2 个基因片段,共有125份样品获得了分型结果,3b为主要的亚型,占48.8%(61/125);其他亚型按照比例依次为3a(30.4%,38/125)、6n(14.4%,18/125)、6a(3.2%,4/125)和1b(3.2%,4/125)。各HCV亚型按性别、婚姻、民族和HIV-1抗体是否阳性差异无统计学意义,按年龄分布差异有统计学意义,45岁以下组亚型多样化。分别计算不同亚型在E1E2和NS5B基因区的基因距离,结果显示3a、3b和6a亚型的基因距离大于1b和6n亚型的基因距离。3a、3b、6a 3种亚型中3b亚型毒株的基因距离大于3a亚型毒株。结论 昆明市IDUs人群中HCV存在5种亚型,3b和3a是主要毒株且在该人群中具有较长的流行时间。     

劳教所内男性吸毒劳教学员减少伤害帮教干预探索

[目的]帮助吸毒人员切实有效地改变不安全行为,预防和遏制艾滋病、性病的传播,充分发挥劳教所集中收容、教育复吸人员的有利条件,进一步探索男性吸毒劳教人员减少伤害的有效方式和途径。[方法]对所内185名吸毒劳教人员,以小组互助的形式,引入心理学团体咨询和同伴教育机制开展干预活动。[结果]项目的开展能有效地改变不安全行为。[结论]为云南劳教戒毒模式的探索做出了有益的尝试。     

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。     

Coinfections by HIV, hepatitis B and hepatitis C in imprisoned injecting drug users

In order to know the prevalence and risk factors for coinfections by human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) among injecting drug users (IDUs), a cross-sectional study was carried out in two prisons of the province of Cantabria, northern Spain. Three hundred and sixty-two IDU inmates were recruited. All inmates were interviewed and their blood tested for HIV, HBV and HCV. Crude and multiple risk factor adjusted for (by polychotomous logistic regression) odds ratios were calculated. Prevalence of HBV-HCV coinfection (42.5%) was higher than HIV-HBV-HCV coinfection (37.3%), whereas monoinfections were very uncommon (overall: 13%). Long-term injectors and reincarceration were the foremost risk factors for both coinfections, showing a trend between the degree of association and the number of viruses infecting a patient. No significant relationship between coinfection status and sexual practices was observed. The results related to coinfections are consistent with previous studies of prevalence and risk factors for HIV, HBV and HCV, in indicating that the high rates of coinfections among IDU inmates emphasise the need to harm-reduction policy across prisons in Spain.