Research Center, Centre Hospitalier de l'Université de Montréal.
Clin Infect Dis. 2014 Mar;58(6):755-61. doi: 10.1093/cid/cit938. Epub 2013 Dec 20.
Notification of hepatitis C virus (HCV) positive status is known to have short-term impacts on subsequent alcohol, drug use and injection behaviors among persons who inject drugs (PWID). It remains to be established whether postscreening behavioral changes extend over time for PWID and whether screening test notification has behavioral impacts among HCV-negative PWID. This study sought to longitudinally assess substance use and injection behaviors after HCV status notification among HCV seroconverters and HCV-negative PWID.
Initially HCV-seronegative PWID (n = 208) were followed prospectively between 2004 and 2011 in Montreal, Canada. Semiannual screening visits included blood sampling and an interview-administered questionnaire assessing substance use and injection behaviors. Multivariable generalized estimating equation analyses were conducted to assess substance use and behavior changes over time and compare changes between HCV seroconverters and HCV-seronegative participants while adjusting for baseline characteristics.
Of the 208 participants (83% male; mean age, 34.7 years, mean follow-up time, 39 months), 69 (33.2%) seroconverted to HCV. A linear decrease in syringe sharing behavior was observed over time after HCV and status notification, whereas a 10% decrease for each additional 3 months of follow-up was observed for injection cocaine and heroin use among HCV seroconverters but not among HCV-seronegative PWID (P < .05). No significant changes were observed in alcohol use.
Our results indicate that notification of HCV-positive status is associated with reduced injection drug use among seroconverters. Among PWID deemed seronegative after screening, there is no sustained trend for change in risk behavior.
已知丙型肝炎病毒（HCV）阳性状态的通知会对注射吸毒者（PWID）随后的酒精、药物使用和注射行为产生短期影响。目前尚不清楚 PWID 的这些行为变化是否会随着时间的推移而持续，以及 HCV 阴性 PWID 的筛查测试通知是否会对其行为产生影响。本研究旨在纵向评估 HCV 血清转换者和 HCV 阴性 PWID 接受 HCV 状态通知后的物质使用和注射行为。
最初，2004 年至 2011 年间，208 名 HCV 血清阴性的 PWID 在加拿大蒙特利尔进行了前瞻性随访。每半年进行一次筛查访视，包括采血和访谈式问卷调查，评估物质使用和注射行为。多变量广义估计方程分析用于评估随着时间的推移物质使用和行为的变化，并在调整基线特征的情况下比较 HCV 血清转换者和 HCV 血清阴性参与者之间的变化。
在 208 名参与者（83%为男性；平均年龄 34.7 岁，平均随访时间 39 个月）中，有 69 名（33.2%）发生了 HCV 血清转换。HCV 和状态通知后，共享注射器的行为呈线性下降，而 HCV 血清转换者的注射可卡因和海洛因使用量每增加 3 个月就会减少 10%，但 HCV 血清阴性的 PWID 则没有观察到这种变化（P<0.05）。酒精使用量没有明显变化。
我们的结果表明，HCV 阳性状态的通知与血清转换者注射毒品使用的减少有关。在筛查后被认为是血清阴性的 PWID 中，没有持续的风险行为变化趋势。
