Public Health Agency, Health Protection Service Northern Ireland, Belfast, Northern Ireland.
European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
J Viral Hepat. 2019 Dec;26(12):1377-1387. doi: 10.1111/jvh.13184. Epub 2019 Aug 18.
From July to August 2016, 4 homeless people who injected drugs (PWID) with acute or recent hepatitis C virus (HCV) infection were reported in Belfast. A multidisciplinary team including public health, homeless and addiction services undertook an investigation to identify risk behaviours and interrupt transmission chains. Recent HCV cases were defined as negative test within the previous year, or reported injecting for less than 1 year; acute cases had tested negative within the previous 6 months. Contacts in the injecting networks of cases were identified for testing. We undertook a cross-sectional survey using structured questionnaires to elicit risk behaviours for PWID and compare behaviours between self-reported hepatitis C positive and negative subjects. During the outbreak investigation until December 2017, 156 PWID were tested and 45 (29%) cases identified, including 7 (16%) recent and 13 (29%) acute infections. 68 PWID, including 12 cases, were interviewed. All respondents reported using heroin, with 76% injecting once or more daily. Sharing was reported for spoons (58%) and filters (53%), but also needles (27%) and syringes (29%). Hepatitis C positive individuals had higher odds to be injecting in public toilets (AOR 17, 95% CI 0.71-400, P < .05) when compared with hepatitis C negative individuals. Hepatitis C positive individuals were more likely to inject in public spaces, but all respondents indicated concerning risk behaviours. We recommend active surveillance with ongoing testing, expanding existing harm reduction programmes and access to bespoke services.
2016 年 7 月至 8 月，贝尔法斯特报告了 4 例无家可归且有近期或急性丙型肝炎病毒（HCV）感染的吸毒者（PWID）。一个多学科小组，包括公共卫生、无家可归者和成瘾服务部门，开展了一项调查，以确定风险行为并阻断传播链。近期 HCV 病例定义为过去一年检测结果为阴性，或报告过去 1 年内有过注射史；急性 HCV 病例则是指过去 6 个月内检测结果为阴性。对病例的注射网络中的接触者进行了检测。我们使用结构问卷进行了横断面调查，以了解 PWID 的风险行为，并比较自报 HCV 阳性和阴性人群的行为。在疫情调查期间（截至 2017 年 12 月），共检测了 156 名 PWID，发现 45 例（29%）病例，包括 7 例（16%）近期感染和 13 例（29%）急性感染。对 68 名 PWID 进行了访谈，其中包括 12 例病例。所有受访者均报告使用海洛因，76%的人每天注射 1 次或更多次。报告了勺子（58%）和过滤器（53%）的共享，还有针（27%）和注射器（29%）的共享。与 HCV 阴性个体相比，HCV 阳性个体在公共厕所注射的可能性更高（比值比 17，95%置信区间 0.71-400，P <.05）。HCV 阳性个体更有可能在公共场所注射，但所有受访者均表示存在令人担忧的风险行为。我们建议进行主动监测和持续检测，扩大现有的减少伤害计划并提供定制服务。
