The Kirby Institute, UNSW Sydney, New South Wales.
Sydney Medical School, The University of Sydney, New South Wales.
Aust N Z J Public Health. 2018 Feb;42(1):52-56. doi: 10.1111/1753-6405.12741. Epub 2017 Nov 22.
To examine factors associated with hepatitis C virus (HCV) infection among a national sample of Indigenous and non-Indigenous people who inject drugs (PWID) in Australia.
Respondents were recruited from Australia's Needle Syringe Program Survey; an annual bio-behavioural surveillance project that monitors HCV antibody prevalence among PWID. Data from 2006-2015 were de-duplicated to retain only one record where individuals participated in >1 survey round. Univariate and multivariable logistic regression examined demographic characteristics and injection-related behaviours associated with exposure to HCV.
Among 17,413 respondents, 2,215 (13%) were Indigenous Australians. Compared to their non-Indigenous counterparts, Indigenous respondents were significantly more likely to be exposed to HCV infection (53% vs. 60% respectively, p<0.001). Among Indigenous respondents, HCV antibody positivity was independently associated with a history of imprisonment (Adjusted Odd Ratio [AOR] 2.13, 95%CI 1.73-2.64), opioid injection (AOR 1.53, 95%CI 11.43-2.16), recruitment in a metropolitan location (AOR 1.27, 95%CI 1.02-1.59), engagement in opioid substitution therapy (AOR 2.83, 95%CI 2.23-3.59) and length of time since first injection (p<0.001).
Indigenous PWID are more likely to be exposed to HCV infection than their non-Indigenous counterparts. Implications for public health: Increased access to culturally sensitive harm reduction programs is required to prevent primary HCV infection and reinfection among Indigenous PWID. Given recent advances in HCV treatment, promotion of treatment uptake among Indigenous PWID may reduce future HCV-related morbidity and mortality.
在澳大利亚全国范围内的注射吸毒者（IDU）中，研究与丙型肝炎病毒（HCV）感染相关的因素，包括土著和非土著人群。
本研究从澳大利亚的针具交换计划调查（一项年度生物行为监测项目，监测 IDU 中 HCV 抗体的流行率）中招募了受访者。对 2006 年至 2015 年的数据进行去重，以保留个体参加>1 次调查轮次的唯一记录。单变量和多变量逻辑回归分析了与 HCV 暴露相关的人口统计学特征和注射相关行为。
在 17413 名受访者中，2215 名（13%）是澳大利亚土著人。与非土著受访者相比，土著受访者更有可能感染 HCV（分别为 53%和 60%，p<0.001）。在土著受访者中，HCV 抗体阳性与有监禁史（调整后的优势比 [AOR] 2.13，95%CI 1.73-2.64）、阿片类药物注射（AOR 1.53，95%CI 11.43-2.16）、在大都市区招募（AOR 1.27，95%CI 1.02-1.59）、接受阿片类药物替代治疗（AOR 2.83，95%CI 2.23-3.59）和首次注射后时间（p<0.001）有关。
土著 IDU 比非土著 IDU 更有可能感染 HCV。这对公共卫生的启示是：需要增加获得文化敏感的减少伤害计划的机会，以防止土著 IDU 发生原发性 HCV 感染和再感染。鉴于 HCV 治疗的最新进展，促进土著 IDU 接受治疗可能会降低未来 HCV 相关发病率和死亡率。
