Department of Epidemiology, MD Anderson Cancer Center, Houston, TX, USA.
Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.
BMC Infect Dis. 2024 Sep 17;24(1):985. doi: 10.1186/s12879-024-09685-3.
Prior research predominantly examined the association between HIV-positive men who have sex with men (MSM) or those using injection drugs and hepatitis C virus (HCV) infection. However, limited attention has been given to understanding the association among HIV-negative MSM who do not inject drugs. This gap leaves apportion of the population unexamined, potentially overlooking important factor that may contribute to the transmission and prevalence of HCV. This study aims to investigate the relationship between non-injection drug use and HCV infection in this population.
In this cross-sectional study, we analyzed data on 118 MSM who reported use of non-injection drugs. The participants were recruited from two inner-city communities in Houston, TX, between 2004 and 2007 and were negative for both HIV and hepatitis B virus infection. Latent class analysis (LCA) was used to identify drug use latent classes. Multinomial logistic regression analysis was used to evaluate the association between drug use latent class and HCV infection.
Four distinct latent classes of drug use were identified: class 1, persons ≥ 42 years of age who used only crack cocaine; class 2, persons approximately 42 years of age who used > 2 drugs; class 3, persons < 42 years of age who used > 5 drugs; and class 4, persons ≥ 42 years of age who used > 6 drugs. Class 4 was significantly associated with HCV infection. The odds of HCV infection in members of class 4 was 17 times higher than in class 2 members (adjusted odds ratio [aOR] = 16.9, 95% confidence interval [CI]: 1.4-205.4) and almost 22 times higher than in class 3 members (aOR = 21.8, 95% CI: 1.5-322.8).
Among MSM with non-injection drug use, the subgroup of individuals who were ≥ 42 years of age and used multiple drugs (including heroin, speedball, methamphetamine, crack cocaine, and marijuana) had a high probability of HCV infection. Public health and education programs, as well as drug treatment and rehabilitation programs, should be developed for this high-risk subgroup of individuals to prevent HCV acquisition and transmission.
先前的研究主要考察了 HIV 阳性男男性行为者（MSM）或注射毒品者与丙型肝炎病毒（HCV）感染之间的关联。然而，对于不注射毒品的 HIV 阴性 MSM 之间的关联，关注甚少。这一差距使得一部分人群未被检查，可能忽略了可能导致 HCV 传播和流行的重要因素。本研究旨在调查该人群中非注射毒品使用与 HCV 感染之间的关系。
在这项横断面研究中，我们分析了 2004 年至 2007 年间在德克萨斯州休斯顿市的两个内城社区招募的 118 名报告使用非注射毒品的 MSM 数据。这些参与者均为 HIV 和乙型肝炎病毒感染阴性。采用潜在类别分析（LCA）来确定药物使用潜在类别。采用多变量逻辑回归分析评估药物使用潜在类别与 HCV 感染之间的关联。
确定了四个不同的药物使用潜在类别：第 1 类，年龄≥42 岁，仅使用可卡因；第 2 类，年龄约为 42 岁，使用>2 种药物；第 3 类，年龄<42 岁，使用>5 种药物；第 4 类，年龄≥42 岁，使用>6 种药物。第 4 类与 HCV 感染显著相关。第 4 类成员感染 HCV 的几率是第 2 类成员的 17 倍（调整后的优势比[aOR] = 16.9，95%置信区间[CI]：1.4-205.4），几乎是第 3 类成员的 22 倍（aOR = 21.8，95% CI：1.5-322.8）。
在使用非注射毒品的 MSM 中，年龄≥42 岁且使用多种药物（包括海洛因、快球、冰毒、可卡因和大麻）的亚组人群 HCV 感染的可能性较高。应针对这一高危亚组人群制定公共卫生和教育计划以及药物治疗和康复计划，以预防 HCV 的获得和传播。
