Zhang Long, Celentano David D, Le Minh Nguyen, Latkin Carl A, Mehta Shruti H, Frangakis Constantine, Ha Tran Viet, Mo Tran Thi, Sripaipan Teerada, Davis Wendy W, Quan Vu Minh, Go Vivian F
Departments of aEpidemiology bHealth, Behavior and Society cBiostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland dDepartment of Health Behavior, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA eThai Nguyen Center for Preventive Medicine, Thai Nguyen, Vietnam.
Eur J Gastroenterol Hepatol. 2015 May;27(5):550-6. doi: 10.1097/MEG.0000000000000321.
Vietnam bears a high burden of hepatitis C virus (HCV) and HIV infection among persons who inject drugs (PWID). The high prevalence of HCV and HIV occurs in a context of stigma and limited preventive interventions for PWID.
This study aims to estimate the prevalence of HCV, HIV, and HIV/HCV coinfection among PWID and to explore their associations with lifetime injection behaviors.
A total of 1434 PWID were recruited from the Thai Nguyen Province of Vietnam between 2005 and 2007. Participants responded to a structured questionnaire and provided blood samples at baseline. A cross-sectional analysis of data collected at baseline was carried out. Factors associated with HCV monoinfection and HIV/HCV coinfection were evaluated by multinomial logistic regression.
The prevalences of HIV and HCV were 35.1 and 88.8%, respectively, and the prevalences of HIV/HCV coinfection and HCV monoinfection were 34.8 and 53.9%, respectively. After adjusting for confounders in multivariate analysis, ever reusing a syringe and needle was found to be significantly associated with HIV monoinfection [adjusted odds ratio (AOR), 3.13; 95% confidence interval (CI), 1.99-4.94] and HIV/HCV coinfection (AOR, 3.34; 95% CI, 2.02-5.51). Ever sharing diazepam or novocaine was also found to be significantly associated with HIV monoinfection (AOR, 2.14; 95% CI, 1.38-3.32) and HIV/HCV coinfection (AOR, 2.47; 95% CI, 1.57-3.90).
Our findings demonstrate a high burden of HIV and HCV infection among PWID in Vietnam. Lifetime injection behaviors, including sharing of diazepam or novocaine, may account for the high prevalence of HIV and HCV. Improving prevention and ensuring access to care remain critically important for this vulnerable population.
越南注射吸毒者(PWID)中丙型肝炎病毒(HCV)和艾滋病毒感染负担沉重。HCV和艾滋病毒的高流行率出现在对PWID存在污名化且预防干预措施有限的背景下。
本研究旨在估计PWID中HCV、艾滋病毒和艾滋病毒/HCV合并感染的流行率,并探讨它们与终生注射行为的关联。
2005年至2007年期间,从越南谅山省招募了总共1434名PWID。参与者回答了一份结构化问卷,并在基线时提供了血样。对基线时收集的数据进行了横断面分析。通过多项逻辑回归评估与HCV单一感染和艾滋病毒/HCV合并感染相关的因素。
艾滋病毒和HCV的流行率分别为35.1%和88.8%,艾滋病毒/HCV合并感染和HCV单一感染的流行率分别为34.8%和53.9%。在多变量分析中对混杂因素进行调整后,发现曾重复使用注射器和针头与艾滋病毒单一感染[调整后的优势比(AOR),3.13;95%置信区间(CI),1.99 - 4.94]和艾滋病毒/HCV合并感染(AOR,3.34;95%CI,2.02 - 5.51)显著相关。还发现曾共用安定或奴夫卡因也与艾滋病毒单一感染(AOR,2.14;95%CI,1.38 - 3.32)和艾滋病毒/HCV合并感染(AOR,2.47;95%CI,1.57 - 3.90)显著相关。
我们的研究结果表明越南PWID中艾滋病毒和HCV感染负担沉重。终生注射行为,包括共用安定或奴夫卡因,可能是艾滋病毒和HCV高流行率的原因。对这一弱势群体而言,改善预防措施并确保获得治疗仍然至关重要。