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爱尔兰注射毒品者中丙型肝炎的发病率。

Incidence of hepatitis C among people who inject drugs in Ireland.

作者信息

Carew Anne Marie, Murphy Niamh, Long Jean, Hunter Kate, Lyons Suzi, Walsh Cathal, Thornton Lelia

机构信息

1Health Research Board, Grattan House, 67-72 Lower Mount Street, Dublin, 2 Ireland.

2HSE Health Protection Surveillance Centre, 25-27 Middle Gardiner Street, Dublin, 1 Ireland.

出版信息

Hepatol Med Policy. 2017 Jan 26;2:7. doi: 10.1186/s41124-017-0024-1. eCollection 2017.

Abstract

BACKGROUND

Comprehensive information on the incidence and duration of hepatitis C virus (HCV) infection for people who inject drugs (PWID) in Ireland is not available. We created an incidence curve of injecting drug use in Ireland and subsequently estimated incidence of hepatitis C virus (HCV) infection.

METHODS

Anonymised data from the National Drug Treatment Reporting System (NDTRS) were used to identify all people who inject drugs (PWIDs) and who entered drug treatment for the first time between 1991 and 2014. A curve, estimating the incidence of injecting, was created to plot PWIDs by year of commencing injecting. The curve was adjusted for missing data on PWIDs in treatment and for PWIDs who were never treated. An adjustment was made to account for injectors who had never shared injecting equipment. The incidence of HCV infection and chronic infection in PWIDs was estimated by applying published rates.

RESULTS

Between 1991 and 2014, 14,320 injectors were registered on NDTRS. The majority were young (median age 25 years), male (74%), lived in Dublin (73%) and injected an opiate (e.g. heroin) (94%). The estimated total number of injectors up to the end of 2014 was 16,382. An estimated 12,423 (95% CI 10,799-13,161) were infected with HCV, and 9,317 (95% CI 8,022-9,996) became chronically infected. The estimated annual number of new HCV infections among PWIDs increased steeply from the late 1970s and peaked in 1998. By 2014, almost 30% of injectors were estimated to have been infected for over 20 years.

CONCLUSIONS

This is the first comprehensive national estimate of the incidence of HCV in PWIDs in Ireland and will inform planning and developing appropriate health care services.

摘要

背景

爱尔兰缺乏针对注射吸毒者(PWID)的丙型肝炎病毒(HCV)感染发病率及持续时间的全面信息。我们绘制了爱尔兰注射吸毒情况的发病率曲线,随后估算了丙型肝炎病毒(HCV)感染的发病率。

方法

利用国家药物治疗报告系统(NDTRS)的匿名数据,确定1991年至2014年间首次接受药物治疗的所有注射吸毒者(PWID)。绘制了一条估算注射发病率的曲线,按开始注射年份对注射吸毒者进行绘图。针对治疗中注射吸毒者的缺失数据以及从未接受治疗的注射吸毒者,对曲线进行了调整。对从未共用过注射设备的注射者也进行了调整。通过应用已公布的发病率估算注射吸毒者中HCV感染和慢性感染的发病率。

结果

1991年至2014年间,NDTRS登记了14320名注射者。大多数为年轻人(中位年龄25岁),男性(74%),居住在都柏林(73%),注射阿片类药物(如海洛因)(94%)。截至2014年底,估计注射者总数为16382人。估计有12423人(95%可信区间10799 - 13161)感染了HCV,9317人(95%可信区间8022 - 9996)发生慢性感染。估计注射吸毒者中新发HCV感染的年人数从20世纪70年代末开始急剧增加,并于1998年达到峰值。到2014年,估计近30%的注射者已感染超过20年。

结论

这是爱尔兰首次对注射吸毒者中HCV发病率进行的全面全国性估算,将为规划和发展适当的医疗服务提供依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de9d/6171004/2b2d83350356/41124_2017_24_Fig1_HTML.jpg

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