Neaigus Alan, Gyarmathy V Anna, Zhao Mingfang, Miller Maureen, Friedman Samuel R, Des Jarlais Don C
Institute for International Research on Youth at Risk, National Development and Research Institutes, Inc., New York, NY 10010, USA.
J Infect Dis. 2007 Apr 1;195(7):1052-61. doi: 10.1086/512081. Epub 2007 Feb 23.
Many heroin users do not inject drugs but may still be at risk of infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV), via sexual or other noninjection-related activity.
Noninjecting heroin users (NIUs) in New York City who were recruited and prospectively followed during March 1996-February 2003 were tested for anti-HIV, anti-hepatitis B core antigen, and anti-HCV and were interviewed about their sexual and other noninjecting risk. A seroconversion is represented by the first positive test result after the last negative test result. Hazard ratios (HRs) (P<.05) were estimated by use of Cox proportional hazards regression.
Of 253 HIV-negative participants, 2 seroconverted (0.29/100 person-years at risk [pyar]); of 184 HBV-negative participants, 16 (3.3/100 pyar); and, of 219 HCV-negative participants, 16 (2.7/100 pyar). Independent predictors of seroconversion were, for HBV, being a female who engages in unprotected receptive anal sex (HR, 6.8), having short-term sex partners (HR, 6.2), and being a male with male sex partners (HR, 5.7); for HCV, being a male who receives money/drugs for sex (HR, 5.6) and sharing noninjecting crack-use equipment (HR, 4.5).
NIUs are at considerable risk of HBV infection via high-risk sex; and, for HCV, via high-risk sexual activity and the sharing of noninjecting crack-use equipment. Interventions in NIUs must seek to reduce high-risk sexual activity and the sharing of noninjecting drug-use equipment.
许多海洛因使用者不注射毒品，但仍可能通过性接触或其他与非注射相关的活动感染人类免疫缺陷病毒（HIV）、乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）。
1996年3月至2003年2月在纽约市招募并进行前瞻性随访的非注射海洛因使用者（NIU）接受了抗HIV、抗乙型肝炎核心抗原和抗HCV检测，并就其性接触及其他非注射相关风险接受了访谈。血清学转换以最后一次阴性检测结果后的首次阳性检测结果表示。使用Cox比例风险回归估计风险比（HR）（P<0.05）。
在253名HIV阴性参与者中，2人发生血清学转换（风险人年[pyar]为0.29/100）；在184名HBV阴性参与者中，16人（3.3/100 pyar）；在219名HCV阴性参与者中，16人（2.7/100 pyar）。血清学转换的独立预测因素，对于HBV来说，是进行无保护的接受性肛交的女性（HR，6.8）、有短期性伴侣（HR，6.2）以及有男性性伴侣的男性（HR，5.7）；对于HCV来说，是通过性行为收钱/毒品的男性（HR，5.6）以及共用非注射用可卡因使用设备（HR，4.5）。
非注射海洛因使用者通过高危性行为感染HBV的风险相当高；而对于HCV，通过高危性活动以及共用非注射用毒品使用设备感染。对非注射海洛因使用者的干预措施必须致力于减少高危性活动以及共用非注射毒品使用设备的行为。
