马里兰州巴尔的摩市注射吸毒者中新冠病毒血清阳性的患病率及其相关因素
Prevalence and correlates of SARS-CoV-2 seropositivity among people who inject drugs in Baltimore, Maryland.
作者信息
Patel Eshan U, Mehta Shruti H, Genberg Becky L, Baker Owen R, Schluth Catherine G, Astemborski Jacquie, Fernandez Reinaldo E, Quinn Thomas C, Kirk Gregory D, Laeyendecker Oliver
机构信息
Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
出版信息
Drug Alcohol Depend Rep. 2023 Aug 9;8:100184. doi: 10.1016/j.dadr.2023.100184. eCollection 2023 Sep.
BACKGROUND
SARS-CoV-2 serosurveys can help characterize disparities in SARS-CoV-2 infection and identify gaps in population immunity. Data on SARS-CoV-2 seroprevalence among people who inject drugs (PWID) are limited.
METHODS
We conducted a cross-sectional study between December 2020 and July 2022 among 561 participants in the AIDS Linked to the IntraVenous Experience (ALIVE) study-a community-based cohort of current and former PWID in Baltimore, Maryland. Serum samples were assayed for infection-induced anti-nucleocapsid (anti-N) and infection and/or vaccination-induced anti-spike-1 (anti-S) SARS-CoV-2 IgG. We estimated adjusted prevalence ratios (aPR) via modified Poisson regression models.
RESULTS
The median age was 59 years, 35% were female, 84% were non-Hispanic Black, and 16% reported recent injection drug use. Anti-N antibody prevalence was 26% and anti-S antibody prevalence was 63%. Anti-N and anti-S antibody prevalence increased over time. Being employed (aPR=1.53 [95%CI=1.11-2.11]) was associated with higher anti-N prevalence, while a cancer history (aPR=0.40 [95%CI=0.17-0.90]) was associated with lower anti-N prevalence. HIV infection was associated with higher anti-S prevalence (aPR=1.13 [95%CI=1.02-1.27]), while younger age and experiencing homelessness (aPR=0.78 [95%CI=0.60-0.99]) were factors associated with lower anti-S prevalence. Substance use-related behaviors were not significantly associated with anti-N or anti-S prevalence.
CONCLUSIONS
SARS-CoV-2 seroprevalence increased over time among current and former PWID, suggesting cumulative increases in the incidence of SARS-CoV-2 infection and vaccination; however, there were disparities in infection-induced seroprevalence and infection and/or vaccine-induced seroprevalence within this study sample. Dedicated prevention and vaccination programs are needed to prevent disparities in infection and gaps in population immunity among PWID during emerging epidemics.
背景
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）血清学调查有助于描述SARS-CoV-2感染的差异，并确定人群免疫中的差距。关于注射吸毒者（PWID）中SARS-CoV-2血清流行率的数据有限。
方法
我们在2020年12月至2022年7月期间对参与“与静脉注射经历相关的艾滋病”（ALIVE）研究的561名参与者进行了一项横断面研究，该研究是马里兰州巴尔的摩市一个以社区为基础的现职和曾职PWID队列。检测血清样本中感染诱导的抗核衣壳（抗N）以及感染和/或疫苗接种诱导的抗刺突1（抗S）SARS-CoV-2 IgG。我们通过修正的泊松回归模型估计调整后的患病率比值（aPR）。
结果
中位年龄为59岁，35%为女性，84%为非西班牙裔黑人，16%报告近期有注射吸毒行为。抗N抗体流行率为26%，抗S抗体流行率为63%。抗N和抗S抗体流行率随时间增加。就业（aPR=1.53[95%置信区间=1.11-2.11]）与较高的抗N流行率相关，而有癌症病史（aPR=0.40[95%置信区间=0.17-0.90]）与较低的抗N流行率相关。HIV感染与较高的抗S流行率相关（aPR=1.13[95%置信区间=1.02-1.27]），而较年轻的年龄和经历无家可归（aPR=0.78[95%置信区间=0.60-0.99]）是与较低的抗S流行率相关的因素。与物质使用相关的行为与抗N或抗S流行率无显著关联。
结论
现职和曾职PWID中SARS-CoV-2血清流行率随时间增加，表明SARS-CoV-2感染和疫苗接种发病率的累积增加；然而，在本研究样本中，感染诱导的血清流行率以及感染和/或疫苗诱导的血清流行率存在差异。在新出现的疫情期间，需要专门的预防和疫苗接种计划来预防PWID中感染的差异和人群免疫中的差距。
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