Cook P A, McVeigh J, Syed Q, Mutton K, Bellis M A
Public Health Sector, School of Health and Human Sciences, Liverpool John Moores University, Liverpool, UK.
Addiction. 2001 Dec;96(12):1787-97. doi: 10.1046/j.1360-0443.2001.961217878.x.
To assess prevalence of, and behavioural risk factors for, hepatitis B and C in drug users both in and out of contact with drugs services.
Cross-sectional survey of hepatitis B and C prevalence using blood samples and self-completed risk factor questionnaires.
Three hundred and sixty injecting drug users (IDUs) in treatment for their drug use, attending syringe exchange schemes (SES), and not in contact with any services in Wirral and Manchester between 1997 and 1999, for whom test results were available for 334 (hepatitis B) and 341 (hepatitis C).
Hepatitis B prevalence differed between groups, from 19% of those not in contact to 41% of those presenting to request a test (p = 0.040). Prevalence of hepatitis C ranged from 48% (SES) to 62% among those presenting for a test (p = 0.233). After multivariate adjustment, hepatitis B was predicted by prison stays (p = 0.030) and injecting for longer (p = 0.003). For hepatitis C, length of injecting career (p = 0.036), having been to prison (p = 0.034), having injected more than one drug type (p < 0.001) and being female (p = 0.037) predicted infection. Overall, 38% had shared some form of injecting equipment in the previous 4 weeks. People recently starting injecting were more likely to share, and sharing was more likely to occur when injecting with only one other user rather than in larger groups. Those who had previously presented for a hepatitis C test, regardless of the result, were less likely to have recently shared injecting equipment.
Behaviours associated with transmission of hepatitis B and C are common among IDUs. In particular, sharing of injecting equipment was more likely in small groups and in those recently beginning injecting. More broadly, chaotic drug use and time in prison were also risk factors for hepatitis infections. When assessing prevalence of hepatitis B and C, our results suggest that figures cannot be extrapolated from those in service contact to those in the wider drug-using population.
评估与毒品服务有接触和无接触的吸毒者中乙型和丙型肝炎的患病率及行为风险因素。
采用血样和自行填写的风险因素问卷对乙型和丙型肝炎患病率进行横断面调查。
1997年至1999年间，在威尔拉尔和曼彻斯特接受吸毒治疗、参加针头交换计划（SES）且未与任何服务机构有接触的360名注射吸毒者（IDU），其中334人（乙型肝炎）和341人（丙型肝炎）有检测结果。
不同组之间乙型肝炎患病率有所不同，未接触者中为19%，前来要求检测者中为41%（p = 0.040）。丙型肝炎患病率在参加针头交换计划者中为48%，前来检测者中为62%（p = 0.233）。多变量调整后，乙型肝炎可通过曾入狱（p = 0.030）和注射时间更长（p = 0.003）来预测。对于丙型肝炎，注射生涯时长（p = 0.036）、曾入狱（p = 0.034）、注射过不止一种毒品类型（p < 0.001）以及女性（p = 0.037）可预测感染情况。总体而言，38%的人在过去4周内曾共用过某种形式的注射器具。最近开始注射的人更有可能共用，且与仅一名其他使用者一起注射时比在更大的群体中更有可能发生共用。那些先前曾接受丙型肝炎检测的人，无论结果如何，最近共用注射器具的可能性较小。
与乙型和丙型肝炎传播相关的行为在注射吸毒者中很常见。特别是，共用注射器具在小群体和最近开始注射的人中更有可能发生。更广泛地说，混乱的吸毒行为和入狱时间也是肝炎感染的风险因素。在评估乙型和丙型肝炎患病率时，我们的结果表明，不能从与服务机构有接触者的数据推断更广泛吸毒人群的数据。
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