在坦桑尼亚，注射毒品者中艾滋病毒、乙型肝炎和丙型肝炎病毒感染的高发率：控制艾滋病毒和病毒性肝炎的潜在绊脚石。
High prevalence of human immunodeficiency virus, hepatitis B and C viral infections among people who inject drugs: a potential stumbling block in the control of HIV and viral hepatitis in Tanzania.
机构信息
Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Field Epidemiology and Laboratory Training Programme, Dar es Salaam, Tanzania.
出版信息
BMC Public Health. 2020 Feb 4;20(1):177. doi: 10.1186/s12889-020-8294-8.
BACKGROUND
Tanzania has witnessed a significant decrease in the prevalence of human immunodeficiency virus (HIV) and viral hepatitis in the general population attributed to several interventional measures. It is uncertain whether this decline has also occurred among people who inject drugs (PWID). This study aimed to determine the seroprevalence of HIV, Hepatitis B and C viruses infection among PWID recruited from their hotspot sites in Dar es Salaam, Tanzania.
METHODS
A cross-sectional study conducted between June and September 2017 recruited PWID from pre-identified hotspot sites using a snowball referral sampling technique. A structured questionnaire was used to obtain information regarding socio-demographic characteristics, behaviour and drug use. Blood was tested for the presence of IgG antibodies against HIV and Hepatitis C virus (HCV) and hepatitis B surface antigen (HBsAg). Data were entered in the computer using excel software and analysed using Statistical Package for Social Sciences version 20.
RESULTS
A total of 219 PWID were recruited, the majority of whom were males (74.9%), unmarried (60.7%), had low education (62.6%) and low income (57.1%). The median age was 39 years, with an inter-quartile range of 35-43. Approximately 32.0% had a history of drug injection for more than 3 years, 79.9% were injecting drugs more than 3 times per day and 47.5% were sharing needles. The overall prevalence of HIV, HBsAg, and HCV was 33.8, 7.8, and 50.2%, respectively. There was serologic evidence of at least one infection for 68.9%, while 22.4% had two or more infections. HIV infection was independently associated with being married, while HCV was associated with injecting drugs for more than 3 years and unprotected sex.
CONCLUSION
Over two-third of PWID had serologic evidence of infection with at least one virus while 22.4% having at least two infections. The high prevalence of HIV and viral hepatitis infections among PWID may hamper initiatives of ending HIV and viral hepatitis epidemics in Tanzania.
背景
坦桑尼亚通过实施多项干预措施，艾滋病毒（HIV）和病毒性肝炎在普通人群中的流行率显著下降。但尚不清楚这一下降是否也发生在注射吸毒者（PWID）中。本研究旨在确定在达累斯萨拉姆的热点地区招募的 PWID 中 HIV、乙型肝炎和丙型肝炎病毒感染的血清流行率。
方法
2017 年 6 月至 9 月期间，采用滚雪球式的推荐抽样技术，从预先确定的热点地区招募 PWID，进行横断面研究。使用结构化问卷获取社会人口统计学特征、行为和药物使用方面的信息。采集血液样本，检测针对 HIV 和丙型肝炎病毒（HCV）的 IgG 抗体以及乙型肝炎表面抗原（HBsAg）。使用 excel 软件将数据输入计算机，并使用统计软件包（SPSS）版本 20 进行分析。
结果
共招募了 219 名 PWID，其中大多数为男性（74.9%）、未婚（60.7%）、受教育程度低（62.6%）和收入低（57.1%）。中位年龄为 39 岁，四分位间距为 35-43 岁。约 32.0%的人有超过 3 年的药物注射史，79.9%的人每天注射毒品超过 3 次，47.5%的人共用针头。HIV、HBsAg 和 HCV 的总流行率分别为 33.8%、7.8%和 50.2%。有 68.9%的人至少有一种感染的血清学证据，而 22.4%的人有两种或两种以上的感染。已婚与 HIV 感染独立相关，而 HCV 与注射吸毒超过 3 年和无保护性行为相关。
结论
超过三分之二的 PWID 有至少一种病毒感染的血清学证据，而 22.4%的人有至少两种感染。PWID 中 HIV 和病毒性肝炎感染的高流行率可能会阻碍坦桑尼亚终结 HIV 和病毒性肝炎流行的努力。
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