Levine O S, Vlahov D, Koehler J, Cohn S, Spronk A M, Nelson K E
Department of Epidemiology, School of Hygiene and Public Health, The Johns Hopkins University, Baltimore, MD 21205, USA.
Am J Epidemiol. 1995 Aug 1;142(3):331-41. doi: 10.1093/oxfordjournals.aje.a117639.
To investigate the epidemiology of hepatitis B virus (HBV) infection among injecting drug users, the authors assessed the prevalence of HBV seromarkers among 2,558 injecting drug users recruited through street outreach in Baltimore, Maryland, in 1988-1989. Eighty percent of the drug users had at least one HBV seromarker. HBV seropositivity was associated with increasing age, duration of injecting drug use, African-American ethnicity, injecting drugs at least once daily, and sharing needles or visiting "shooting galleries" during the previous 11 years, but not with high-risk sexual behaviors or a history of sexually transmitted disease. This finding is possibly due to the relative inefficiency of sexual transmission as compared with parenteral transmission in injecting drug users. In addition, HBV seropositivity was strongly associated with seropositivity for hepatitis C virus and human immunodeficiency virus. The authors conclude that HBV transmission among injecting drug users occurs primarily through the sharing of contaminated drug injecting equipment rather than through sexual relations, and that efforts to prevent HBV infection must target injecting drug users early in their injecting careers.
为调查注射吸毒者中乙型肝炎病毒（HBV）感染的流行病学情况，作者评估了1988 - 1989年在马里兰州巴尔的摩通过街头外展招募的2558名注射吸毒者中HBV血清标志物的流行情况。80%的吸毒者至少有一项HBV血清标志物。HBV血清阳性与年龄增长、注射吸毒时间、非裔美国人种族、每天至少注射一次毒品以及在过去11年中共用针头或前往“射击场”有关，但与高危性行为或性传播疾病史无关。这一发现可能是由于与注射吸毒者的肠道外传播相比，性传播效率相对较低。此外，HBV血清阳性与丙型肝炎病毒和人类免疫缺陷病毒的血清阳性密切相关。作者得出结论，注射吸毒者中的HBV传播主要通过共用受污染的毒品注射设备而非通过性关系发生，并且预防HBV感染的努力必须在注射吸毒者的注射生涯早期就针对他们。
