Maher Lisa, Jalaludin Bin, Chant Kerry G, Jayasuriya Rohan, Sladden Tim, Kaldor John M, Sargent Penny L
National Centre in HIV Epidemiology and Clinical Research and School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
Addiction. 2006 Oct;101(10):1499-508. doi: 10.1111/j.1360-0443.2006.01543.x.
To determine the incidence of hepatitis C virus (HCV) infection and identify risk factors for seroconversion.
Prospective cohort study. Participants were recruited through direct approaches, street-based outreach, methadone and sexual health clinics and needle and syringe programmes.
Urban, regional and rural settings in New South Wales, Australia.
Injecting drug users (IDUs) (n = 584) were screened and tested for exposure to HCV. Between 1999 and 2002 antibody HCV negative IDUs (n = 368) were enrolled and followed-up every 3-6 months until seroconversion or study completion.
Interviewer-administered baseline and follow-up questionnaires consisted of 131 items and included demographics, drug use and risk behaviour. Approximately 10 cc of whole blood was drawn at each visit. Specimens were stored at -70C and serology performed using one or two third-generation enzyme-linked immunosorbent assays and polymerase chain reaction testing.
Sixty-eight seroconversions were observed and incidence was 30.8 per 100 person-years, with incidence in IDUs injecting < 1 year, 133 per 100 person-years. Independent predictors of seroconversion were female gender, duration of injecting, injecting cocaine, shared use of filters and recruitment strategy.
Women, new initiates and IDUs recruited via outreach appear to be at increased risk of infection. Results confirm the significance of cocaine injection as a risk factor and provide the first evidence outside North America of the link between shared use of drug preparation equipment and incident HCV infection. Prevention efforts should attempt to raise awareness of the risks associated with drug sharing and, in particular, the role of potentially contaminated syringes in HCV infection.
确定丙型肝炎病毒（HCV）感染的发生率，并识别血清转化的危险因素。
前瞻性队列研究。通过直接接触、街头外展服务、美沙酮和性健康诊所以及针头和注射器项目招募参与者。
澳大利亚新南威尔士州的城市、地区和农村地区。
对注射吸毒者（IDUs）（n = 584）进行HCV暴露筛查和检测。1999年至2002年间，抗体HCV阴性的IDUs（n = 368）被纳入研究，并每3 - 6个月随访一次，直至血清转化或研究结束。
由访谈者实施的基线和随访问卷包含131个项目，包括人口统计学、药物使用和风险行为。每次随访抽取约10毫升全血。样本储存在-70°C，血清学检测采用一或两种第三代酶联免疫吸附试验和聚合酶链反应检测。
观察到68例血清转化，发病率为每100人年30.8例；注射时间<1年的IDUs发病率为每100人年133例。血清转化的独立预测因素为女性、注射时间、注射可卡因、共用过滤器和招募策略。
女性、新开始注射吸毒者以及通过外展服务招募的IDUs感染风险似乎增加。结果证实了注射可卡因作为危险因素的重要性，并提供了北美以外首个关于共用药物制备设备与HCV感染事件之间联系的证据。预防措施应努力提高对药物共用相关风险的认识，特别是潜在受污染注射器在HCV感染中的作用。
