Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.
Semin Liver Dis. 2011 Nov;31(4):340-6. doi: 10.1055/s-0031-1297923. Epub 2011 Dec 21.
The widespread availability of injectable therapies and increase in illicit injection drug use were responsible for the rapid emergence of hepatitis C virus (HCV) infection in the latter half of the 20th century. Iatrogenic exposures and illicit injection drug use have been the predominant risk factors for HCV transmission worldwide. In developing countries, unsafe therapeutic injection practices appear to be responsible for most infections. In developed countries, donor testing has virtually eliminated transfusion-related infections, but infections transmitted to patients by unsafe injections practices is an emerging problem. Injection drug use is the major risk factor for HCV; incidence remains high among new injectors, and this behavior likely contributes to and/or confounds reported associations between HCV-positive persons and histories of noninjection drug use, tattooing, and incarceration. Increased use of illegal drugs also may play a role in the emergence of sexually transmitted HCV infections among HIV-positive men who have sex with men. Ongoing monitoring of the epidemiology of HCV infection is crucial for preventing future infections.
在 20 世纪后半叶，注射治疗的广泛应用和非法注射毒品的增加导致丙型肝炎病毒（HCV）感染迅速出现。在全球范围内，医源性暴露和非法注射毒品是 HCV 传播的主要危险因素。在发展中国家，不安全的治疗性注射操作似乎是大多数感染的原因。在发达国家，献血者检测几乎消除了输血相关感染，但不安全注射操作导致的感染已成为一个新出现的问题。注射毒品使用是 HCV 的主要危险因素；新注射者的发病率仍然很高，这种行为可能导致和/或混淆报告的 HCV 阳性者与非注射毒品使用、纹身和监禁的历史之间的关联。非法毒品使用的增加也可能在 HIV 阳性的男男性行为者中导致 HCV 的性传播感染。对 HCV 感染的流行病学进行持续监测对于预防未来感染至关重要。
