Liu Jyh-You, Lin Hsi-Hsun, Liu Yung-Ching, Lee Susan Shin-Jung, Chen Ya-Lei, Hung Chien-Ching, Ko Wen-Chien, Huang Chun-Kai, Lai Chung-Hsu, Chen Yao-Shen, Shih Yi-Li, Chung Hsing-Chun, Liang Shiou-Haur, Lin Jiun-Nong
Department of Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan, Republic of China.
Clin Infect Dis. 2008 Jun 1;46(11):1761-8. doi: 10.1086/587992.
An outbreak of human immunodeficiency virus (HIV) type 1 infection among injection drug users (IDUs) occurred in Taiwan, and thereafter, injection drug use became the most frequent risk factor for HIV infection in Taiwan. We sought to study the prevalence of and genotypes causing hepatitis C virus (HCV) infection among HIV-infected IDUs in Taiwan.
A multicenter, longitudinal cohort study of 990 HIV-infected IDUs was conducted from 1993 through 2006. Blood samples were collected and analyzed for the presence of antibody to HCV and to determine the genotype of HCV.
The overall prevalence of HCV infection among HIV-infected IDUs was 96.6%. The annual prevalence increased from 65.5% before 2002 to 98.6% in 2006. The main circulating HCV genotypes were 1a (accounting for 29.2% of samples), 6a (23.5%), and 3a (20.2%), whereas 1b, the most predominant genotype circulating in the general population in Taiwan, accounted for only 13.2% of samples. Genotypes 2b (accounting for 6.6% of samples), 6k (2.9%), 2a (1.6%), 6g (1.6%), and 3b (1.2%) were present in only a few IDUs. Multivariate logistic regression analysis revealed that duration of injection drug use and a travel history to China or Southeast Asia were significantly associated with infection due to HCV genotypes 1a, 3, and 6.
Our study demonstrated a high prevalence of HCV infection among HIV-infected IDUs in Taiwan, with a predominance of infection due to genotypes 1a, 6a, and 3a, as a result of the impact of IDUs' behavior and their drug trafficking route. Our study revealed that HCV infection in IDUs originated from a geographically large transmission network that was mainly distinct from that associated with other HCV-infected individuals; this transmission network has also been documented in association with HIV infection in IDUs.
台湾地区曾爆发过一起注射吸毒者感染1型人类免疫缺陷病毒（HIV）的疫情，此后，注射吸毒成为台湾地区HIV感染最常见的危险因素。我们试图研究台湾地区HIV感染的注射吸毒者中丙型肝炎病毒（HCV）感染的患病率及相关基因型。
1993年至2006年对990名HIV感染的注射吸毒者进行了一项多中心纵向队列研究。采集血样并分析抗HCV抗体的存在情况，以确定HCV的基因型。
HIV感染的注射吸毒者中HCV感染的总体患病率为96.6%。年患病率从2002年前的65.5%增至2006年的98.6%。主要流行的HCV基因型为1a（占样本的29.2%）、6a（23.5%）和3a（20.2%），而台湾地区普通人群中最主要流行的基因型1b仅占样本的13.2%。2b（占样本的6.6%）、6k（2.9%））、2a（1.6%）、6g（1.6%）和3b（1.2%）基因型仅在少数注射吸毒者中出现。多因素logistic回归分析显示，注射吸毒持续时间以及到中国大陆或东南亚的旅行史与1a、3和6型HCV感染显著相关。
我们研究表明，台湾地区HIV感染的注射吸毒者中HCV感染患病率很高，由于注射吸毒者行为及其毒品贩运途径的影响，主要以1a、6a和3a基因型感染为主。我们的研究表明，注射吸毒者中的HCV感染源自一个地域广泛的传播网络，该网络主要不同于与其他HCV感染者相关的传播网络；这一传播网络在注射吸毒者HIV感染中也有记录。
