Thomas D L, Vlahov D, Solomon L, Cohn S, Taylor E, Garfein R, Nelson K E
Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Medicine (Baltimore). 1995 Jul;74(4):212-20. doi: 10.1097/00005792-199507000-00005.
Injection drug users are at high risk for hepatitis C virus (HCV) infection. In Baltimore, Maryland, the prevalence of anti-HCV is greater among injection drug users who are black, human immunodeficiency virus (HIV) infected, have injected longer, have injected more frequently, and have injected cocaine than among other injection drug users. HCV infection occurs quickly after the initiation of injecting illicit drugs, with 78% of study participants anti-HCV positive after 2 years of injecting. The prevalence of anti-HCV among injection drug users does not appear to be related to socioeconomic factors or sexual practices. Some injection drug users remain free of anti-HCV even after years of injecting and serologic evidence of other bloodborne pathogens. Some of these injection drug users have HCV infection, demonstrated by HCV RNA in their sera. However, the basis for viral persistence in the absence of anti-HCV and for the absence of HCV infection in long-term drug users is not known. Further studies are indicated to determine the mechanism or mechanisms for the absence of anti-HCV in persons exposed to the virus, because the biologic basis for this condition may elucidate the elements missing in the immune response of the majority of HCV-exposed persons who acquire persistent infection. In addition, interventions to prevent HCV infections should be applied in populations at risk for injection drug use early or before drug use begins.
注射吸毒者感染丙型肝炎病毒（HCV）的风险很高。在马里兰州巴尔的摩，与其他注射吸毒者相比，黑人、感染人类免疫缺陷病毒（HIV）、注射时间更长、注射频率更高以及注射过可卡因的注射吸毒者中抗-HCV的流行率更高。开始注射非法药物后很快就会发生HCV感染，注射2年后78%的研究参与者抗-HCV呈阳性。注射吸毒者中抗-HCV的流行率似乎与社会经济因素或性行为无关。一些注射吸毒者即使在注射多年且有其他血源性病原体的血清学证据后仍未感染抗-HCV。其中一些注射吸毒者有HCV感染，其血清中的HCV RNA可证明这一点。然而，在没有抗-HCV的情况下病毒持续存在的基础以及长期吸毒者未感染HCV的原因尚不清楚。需要进一步研究以确定接触病毒者未感染抗-HCV的机制，因为这种情况的生物学基础可能会阐明大多数接触HCV并获得持续感染的人免疫反应中缺失的因素。此外，应在有注射吸毒风险的人群中尽早或在开始吸毒之前采取预防HCV感染的干预措施。
