Hagan H, Jarlais D C, Friedman S R, Purchase D, Alter M J
Seattle-King County Department of Public Health, Wash. 98104, USA.
Am J Public Health. 1995 Nov;85(11):1531-7. doi: 10.2105/ajph.85.11.1531.
This case-control study examined the association between syringe exchange use and hepatitis B and C in injection drug users.
Case patients included 28 injection drug users with acute hepatitis B and 20 with acute hepatitis C reported to the health department in a sentinel hepatitis surveillance county; control subjects were injection drug users with no markers of exposure to hepatitis B or C (n = 38 and 26, respectively) attending health department services during the same period. Data were abstracted from clinic records.
Seventy-five percent of case patients with hepatitis B and 26% of control subjects had never used the exchange; similar proportions were found for the hepatitis C case and control groups. After adjustment for demographic characteristics and duration of injecting drugs, nonuse of the exchange was associated with a sixfold greater risk of hepatitis B (odds ratio [OR] = 5.5; 95% confidence interval [CI] = 1.5, 20.4) and a sevenfold greater risk of hepatitis C (OR = 7.3; 95% CI = 1.6, 32.8).
The results suggest that use of the exchange led to a significant reduction in hepatitis B and hepatitis C in the county and may have also prevented a substantial proportion of human immunodeficiency virus infections in injection drug users.
本病例对照研究调查了注射吸毒者中注射器交换项目的使用与乙型和丙型肝炎之间的关联。
病例组患者包括在一个哨点性肝炎监测县向卫生部门报告的28例急性乙型肝炎注射吸毒者和20例急性丙型肝炎注射吸毒者；对照组为同期在卫生部门接受服务、无乙型或丙型肝炎暴露标志物的注射吸毒者（分别为38例和26例）。数据从临床记录中提取。
75%的乙型肝炎病例患者和26%的对照者从未使用过注射器交换项目；丙型肝炎病例组和对照组的比例相似。在对人口统计学特征和注射吸毒持续时间进行调整后，未使用注射器交换项目与患乙型肝炎的风险高6倍相关（比值比[OR]=5.5；95%置信区间[CI]=1.5, 20.4），与患丙型肝炎的风险高7倍相关（OR=7.3；95%CI=1.6, 32.8）。
结果表明，注射器交换项目的使用使该县乙型和丙型肝炎显著减少，并且可能还预防了很大比例的注射吸毒者感染人类免疫缺陷病毒。
