Department of Mathematics and Statistics, University of Strathclyde, Livingstone Tower, 26 Richmond Street, Glasgow G1 1HX, UK.
Int J Drug Policy. 2011 Mar;22(2):102-8. doi: 10.1016/j.drugpo.2010.10.007. Epub 2010 Nov 26.
In order to develop new ways to prevent Hepatitis C virus (HCV) transmission amongst injecting drug users (IDUs), it is necessary to fully understand the dynamics of this disease. We reviewed the evidence on three key areas of HCV transmission in this population: the rate of acute HCV infection amongst IDUs who have spontaneously resolved a previous infection, the rate of chronic HCV infection amongst IDUs who have spontaneously resolved a previous infection, and the ability of IDUs to be re-infected with either the same or a different HCV genotype.
A literature search of PUBMED (January 1950 to January 2009), EMBASE (January 1980 to January 2009) and PsycINFO (January 1967 to January 2009) for English language, primary research papers was undertaken to identify longitudinal studies examining HCV re-infection following spontaneous viral clearance amongst IDUs.
The systematic review identified three studies that satisfied the inclusion and exclusion criteria. Regarding the risk of acute HCV infection amongst IDUs, the findings from the three studies were conflicting and thus provided no compelling evidence in support of an increased or decreased risk of acute infection amongst IDUs who have spontaneously resolved compared to those previously uninfected. Limited evidence was found from two studies to support a reduced risk of subsequent chronic HCV infection in those who have previously spontaneously resolved an infection. Further, two studies found IDUs who spontaneously resolved an infection can be re-infected (with comparable proportions) with either the same or a different HCV genotype.
The limited, and sometimes contradictory, evidence published in the worldwide literature highlights the need for more longitudinal studies of IDUs to fully understand the dynamics of the disease in this population.
为了开发新的方法来预防在注射吸毒者（IDUs）中传播丙型肝炎病毒（HCV），有必要充分了解该疾病的动态。我们综述了在该人群中 HCV 传播的三个关键领域的证据：以前感染已自发清除的 IDUs 中急性 HCV 感染的比率，以前感染已自发清除的 IDUs 中慢性 HCV 感染的比率，以及 IDUs 重新感染相同或不同 HCV 基因型的能力。
在 PUBMED（1950 年 1 月至 2009 年 1 月）、EMBASE（1980 年 1 月至 2009 年 1 月）和 PsycINFO（1967 年 1 月至 2009 年 1 月）上进行了英语原始研究文献的文献检索，以确定对 IDUs 自发清除后 HCV 再感染进行纵向研究的研究。
系统综述确定了三项符合纳入和排除标准的研究。关于 IDUs 中急性 HCV 感染的风险，三项研究的结果相互矛盾，因此没有令人信服的证据支持与以前未感染的 IDUs 相比，自发清除的 IDUs 急性感染的风险增加或降低。仅有两项研究发现，以前自发清除感染的人，随后慢性 HCV 感染的风险降低。此外，两项研究发现 IDUs 自发清除感染后可以再次感染（比例相当）相同或不同的 HCV 基因型。
全世界文献中发表的有限的、有时相互矛盾的证据强调了需要对 IDUs 进行更多的纵向研究，以充分了解该人群中疾病的动态。
