Selgelid Michael J, Jamrozik Euzebiusz
Monash Bioethics Centre, Monash University, Melbourne, AUSTRALIA.,
Monash Bioethics Centre, Monash University, Melbourne, AUSTRALIA, Department of General Medicine, Royal Melbourne Hospital, Melbourne, AUSTRALIA.,
Indian J Med Ethics. 2018 Oct-Dec;3(4):263-266. doi: 10.20529/IJME.2018.073. Epub 2018 Sep 18.
Human infection challenge studies (HCS) involve intentionally infecting research participants with pathogens, often with the ultimate aim of developing new interventions against infectious diseases. Despite ethical concerns about research involving vulnerable populations, there are both scientific and ethical reasons to consider conducting more HCS in low- and middle-income countries where neglected diseases are often endemic. HCS researchers can reduce the risks to participants (and the risks of transmission from participants to others) by controlling multiple factors (eg those related to the laboratory environment, participant selection, the pathogen, and the timing of treatment); but HCS nonetheless raise important ethical issues, some of which may be particularly pertinent to HCS in endemic settings. This article provides background on HCS in general, as well as recent HCS in low- and middle-income countries, and an overview of the ethical issues associated with HCS in endemic settings.
人类感染挑战研究（HCS）涉及故意让研究参与者感染病原体，其最终目的通常是开发针对传染病的新干预措施。尽管对于涉及弱势群体的研究存在伦理方面的担忧，但在被忽视疾病往往为地方病的低收入和中等收入国家，仍有科学和伦理方面的理由考虑开展更多的人类感染挑战研究。人类感染挑战研究的研究人员可以通过控制多个因素（例如与实验室环境、参与者选择、病原体和治疗时机相关的因素）来降低参与者面临的风险（以及参与者向他人传播的风险）；但人类感染挑战研究仍然引发了重要的伦理问题，其中一些问题可能与地方病环境中的人类感染挑战研究特别相关。本文提供了关于一般人类感染挑战研究的背景信息，以及低收入和中等收入国家近期的人类感染挑战研究情况，并概述了地方病环境中与人类感染挑战研究相关的伦理问题。
