Aye N S, Oo M M, Harries A D, Mon M M, Hone S, Oo H N, Wan N M A
Department of Medical Research, Ministry of Health and Sports, Nay Pyi Taw, Myanmar.
International Union Against Tuberculosis and Lung Disease (The Union), Mandalay, Myanmar.
Public Health Action. 2018 Dec 21;8(4):202-210. doi: 10.5588/pha.18.0050.
Two drug treatment centres (DTCs) for people who inject drugs (PWID) and are enrolled in methadone maintenance therapy (MMT), Yangon, Myanmar. To determine, in PWID enrolled for MMT from 2015 to 2017, 1) testing uptake and results for human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV); 2) risk factors for infection; and 3) retention in care and risk factors for loss to follow-up (LTFU). Cohort study using secondary data. Of 642 PWID, 578 (90.0%) were tested for HIV, HBV and/or HCV. Overall, 404 (69.9%) were infected: 316 (78.2%) had one infection and the remainder had dual/triple infections. Testing uptake was generally better in 2015 and 2016 than in 2017. Prevalence of HIV infection was 15-17%, for HBV it was 4-7%, and for HCV it was 68-76%. Age >30 years, being single and duration of drug use were independent risk factors for infection. Retention in MMT at 6 months was 76% and declined thereafter. Experimental use of drugs and needle sharing were independent risk factors for LTFU. PWID enrolled in MMT in Yangon had high rates of HIV, HBV and HCV, and retention in care declined with time. Ways to improve individual tracing, programmatic retention and linkage to care are needed.
缅甸仰光的两个针对注射吸毒者且参加美沙酮维持治疗的药物治疗中心。为了确定2015年至2017年参加美沙酮维持治疗的注射吸毒者：1）人类免疫缺陷病毒（HIV）、乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）的检测接受情况及结果；2）感染的危险因素；3）治疗留存率及失访（LTFU）的危险因素。使用二手数据进行队列研究。在642名注射吸毒者中，578名（90.0%）接受了HIV、HBV和/或HCV检测。总体而言，404名（69.9%）被感染：316名（78.2%）感染一种病毒，其余为双重/三重感染。2015年和2016年的检测接受情况总体上比2017年更好。HIV感染率为15 - 17%，HBV为4 - 7%，HCV为68 - 76%。年龄>30岁、单身及吸毒时长是感染的独立危险因素。美沙酮维持治疗6个月时的留存率为76%，此后下降。尝试吸毒和共用针头是失访的独立危险因素。仰光参加美沙酮维持治疗的注射吸毒者HIV、HBV和HCV感染率高，且治疗留存率随时间下降。需要改进个体追踪、项目留存率及与护理的联系方法。
