Des Jarlais Don C, Perlis Theresa, Arasteh Kamyar, Torian Lucia V, Hagan Holly, Beatrice Sara, Smith Lou, Wethers Judith, Milliken Judith, Mildvan Donna, Yancovitz Stanley, Friedman Samuel R
Beth Israel Medical Center, New York, NY 10038, USA.
AIDS. 2005 Oct;19 Suppl 3:S20-5. doi: 10.1097/01.aids.0000192066.86410.8c.
To assess trends in HIV, hepatitis C virus (HCV) and HIV/HCV infection among injecting drug users (IDU) from 1990 to 2001 in New York City. The 1990-2001 time period included a very large expansion of syringe exchange in New York City, from 250,000 to 3,000,000 syringes exchanged annually.
Cross-sectional seroprevalence surveys of IDU entering drug abuse treatment in New York City, with sample sizes for HCV of 72 in 1990-1991 and 412 in 2000-2001. A structured risk behavior questionnaire was administered, and HIV and HCV testing were conducted. HCV testing was performed on de-linked stored serum samples.
Over the 1990-2001 period, HIV prevalence declined from 54 to 13%. HCV prevalence declined from 80 to 59% among HIV-seronegative individuals, and from 90 to 63% overall. The estimated HCV incidence in 2000-2001 among new injectors was 18 per 100 person-years at risk.
The large-scale expansion of syringe exchange was temporally associated with large reductions in both HIV and HCV prevalence. The prevalence and incidence of HCV, however, still remain at high levels among IDU in New York City.
评估1990年至2001年纽约市注射吸毒者中艾滋病毒、丙型肝炎病毒（HCV）及艾滋病毒/丙型肝炎病毒合并感染的趋势。1990 - 2001年期间，纽约市注射器交换项目大幅扩张，每年交换的注射器数量从25万支增至300万支。
对进入纽约市药物滥用治疗机构的注射吸毒者进行横断面血清流行率调查，1990 - 1991年丙型肝炎病毒的样本量为72例，2000 - 2001年为412例。采用结构化风险行为问卷，并进行艾滋病毒和丙型肝炎病毒检测。丙型肝炎病毒检测在脱钩保存的血清样本上进行。
在1990 - 2001年期间，艾滋病毒流行率从54%降至13%。在艾滋病毒血清阴性个体中，丙型肝炎病毒流行率从80%降至59%，总体从90%降至63%。2000 - 2001年新注射吸毒者中丙型肝炎病毒的估计发病率为每100人年18例。
注射器交换项目的大规模扩张在时间上与艾滋病毒和丙型肝炎病毒流行率大幅下降相关。然而，纽约市注射吸毒者中丙型肝炎病毒的流行率和发病率仍处于较高水平。
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