Nielsen Stine, Gassowski Martyna, Wenz Benjamin, Bannert Norbert, Bock Claus-Thomas, Kücherer Claudia, Ross R Stefan, Bremer Viviane, Marcus Ulrich, Zimmermann Ruth
1Department for Infectious Disease Epidemiology, Division for HIV/AIDS, STI and Blood-borne Infections, Robert Koch Institute, Berlin, Germany.
2Charité University Medicine, Berlin, Germany.
Hepatol Med Policy. 2016 Sep 1;1:8. doi: 10.1186/s41124-016-0016-6. eCollection 2016.
People who inject drugs (PWID) are disproportionately affected by both HIV and hepatitis C infection (HCV). Awareness of infection status is essential to ensure linkage to appropriate healthcare for those infected, who need treatment and regular follow-up, as well as for uninfected individuals, who need access to targeted testing and counselling services. In this paper we compare self-reported HIV and HCV status with serological markers of infection among PWID recruited through respondent driven sampling.
From 2011 through 2014, biological and behavioural data was collected from 2,077 PWID in Germany. Dried blood spots from capillary blood samples were collected and screened for HCV antibodies, HCV RNA and HIV-1/-2 antibodies. HIV reactive samples were confirmed by Western blot.
Laboratory testing revealed that 5 % were infected with HIV and 81 % were aware of being infected. Chronic HCV infection was detected in 41 % of the participants, 2 % had an acute HCV infection, 22 % had a cleared infection, and 34 % were unexposed to HCV. The concordance between self-reported and measured HCV status was lower than for HIV, with 73 % of those with chronic HCV infection being aware of their infection.
We found a relatively high awareness of HIV and HCV infection status among PWID. Nevertheless, access to appropriate testing, counselling and care services targeted to the needs of PWID should be further improved, particularly concerning HCV.
Ethical approval was received from the ethics committee at the medical university of Charité, Berlin, Germany in May 2011 and with an amendment approved retrospectively on 19/11/2012 (No EA4/036/11). The German Federal Commissioner for Data Protection and Freedom of Information approved the study protocol retrospectively on 29/11/2012 (III-401/008#0035).
注射毒品者（PWID）受艾滋病毒（HIV）和丙型肝炎病毒（HCV）感染的影响尤为严重。了解感染状况对于确保感染者与适当的医疗保健建立联系至关重要，感染者需要治疗和定期随访，未感染者则需要获得针对性检测和咨询服务。在本文中，我们比较了通过应答者驱动抽样招募的注射毒品者自我报告的HIV和HCV感染状况与感染的血清学标志物。
2011年至2014年期间，收集了德国2077名注射毒品者的生物学和行为数据。采集毛细血管血样的干血斑，检测HCV抗体、HCV RNA和HIV-1/-2抗体。HIV反应性样本通过免疫印迹法确认。
实验室检测显示，5%的人感染了HIV，其中81%的人知晓自己已感染。41%的参与者检测出慢性HCV感染，2%为急性HCV感染，22%感染已清除，34%未接触过HCV。自我报告的HCV感染状况与检测结果的一致性低于HIV，慢性HCV感染者中73%知晓自己的感染情况。
我们发现注射毒品者对HIV和HCV感染状况的知晓率相对较高。然而，仍应进一步改善针对注射毒品者需求的适当检测、咨询和护理服务的可及性，尤其是在HCV方面。
2011年5月，德国柏林夏里特医科大学伦理委员会批准了本研究的伦理许可，并于2012年11月19日追溯批准了一项修正案（编号EA4/036/11）。德国联邦数据保护和信息自由专员于2012年11月29日追溯批准了研究方案（III-401/008#0035）。
