Kirby Institute, University of New South Wales, Sydney, Australia.
Am J Public Health. 2013 Aug;103(8):1436-44. doi: 10.2105/AJPH.2012.301206. Epub 2013 Jun 13.
We examined trends in HCV incident infection among injection drug users (IDUs) attending needle and syringe programs (NSPs) in Australia in 1995 to 2010.
We created a passive retrospective cohort of 724 IDUs who tested negative for HCV antibodies by a simple deterministic method linking partial identifiers to find repeat respondents in annual cross-sectional serosurveillance.
We identified 180 HCV seroconversions over the study period, for a pooled incidence density of 17.0 per 100 person-years (95% confidence interval [CI] = 14.68, 19.66). Incidence density declined, from a high of 30.8 per 100 person-years (95% CI = 21.3, 44.6) in 2003 to a low of 4.0 (95% CI = 1.3, 12.3) in 2009.
A decline in HCV incidence among Australian IDUs attending NSPs coincided with considerable expansion of harm reduction programs and a likely reduction in the number of IDUs, associated with significant changes in drug markets. Our results demonstrate the capacity of repeat cross-sectional serosurveillance to monitor trends in HCV incidence and provide a platform from which to assess the impact of prevention and treatment interventions.
我们调查了 1995 年至 2010 年澳大利亚注射吸毒者（IDU）参加针具交换项目（NSP）时丙型肝炎病毒（HCV）新发感染的趋势。
我们通过一种简单的确定性方法创建了一个被动的回顾性队列，将部分标识符联系起来，以找到年度横断面血清监测中的重复应答者，其中包括 724 名 HCV 抗体阴性的 IDU。
在研究期间，我们发现了 180 例 HCV 血清转换，累积发病率密度为 17.0/100人年（95%置信区间[CI] = 14.68，19.66）。发病率密度从 2003 年的 30.8/100 人年（95%CI = 21.3，44.6）高峰下降到 2009 年的 4.0/100 人年（95%CI = 1.3，12.3）。
参加 NSP 的澳大利亚 IDU 中 HCV 发病率的下降与减少伤害方案的大幅扩展以及 IDU 人数的减少有关，这与毒品市场的显著变化有关。我们的结果表明，重复横断面血清监测有能力监测 HCV 发病率的趋势，并为评估预防和治疗干预措施的效果提供了一个平台。
