Rhodes T, Hunter G M, Stimson G V, Donoghoe M C, Noble A, Parry J, Chalmers C
Centre for Research on Drugs and Health Behaviour, University of London, UK.
Addiction. 1996 Oct;91(10):1457-67. doi: 10.1046/j.1360-0443.1996.911014575.x.
Concerns about the risks of HIV infection among drug injectors have eclipsed concerns about the prevalence and transmission of hepatitis, and in particular hepatitis B virus infection. Findings are reported from surveys undertaken with two separate community-recruited samples of drug injectors in London collected in 1992 (n = 505) and in 1993 (n = 507). Anonymized confirmed testing of saliva shows 51.5% of drug injectors in 1992 and 47.9% in 1993 to be antibody positive to the core antigen of hepatitis B virus (anti-HBc). Approximately half of the drug injectors confirmed as anti-HBc positive were unaware that they had been infected with hepatitis. Anti-HIV-1 prevalence was considerably lower at 7.0% in 1992 and 6.9% in 1993. Multivariate analyses showed anti-HBc positivity to be most likely among older injectors with longer injecting careers who had a history of having shared used needles and syringes. HIV-1 positivity was also associated with a history of having shared injecting equipment as well as with recent sharing (i.e. in the last 6 months). Unlike anti-HBc positivity, there were no associations between HIV-1 positivity and age or length of injecting career. Younger injectors with shorter injecting careers were more likely to report recent sharing of used injecting equipment than older injectors with longer injecting careers. We note the potential for continued transmission of HBV and HIV-1, particularly among younger injectors. We recommend an integrated strategy to maximize the health of drug injectors, of which HIV and HBV prevention is a part. There is a need to widen the availability of HBV vaccinations for HBV negative drug injectors and their sexual partners and for clear guidelines to drug injectors about the relative efficacy of bleach to disinfect injecting equipment of HBV and HIV.
对吸毒者感染艾滋病毒风险的担忧，使人们对肝炎尤其是乙型肝炎病毒感染的流行情况和传播的担忧黯然失色。本文报告了对1992年（n = 505）和1993年（n = 507）在伦敦通过社区招募的两个独立吸毒者样本进行调查的结果。对唾液进行匿名确认检测显示，1992年51.5%的吸毒者和1993年47.9%的吸毒者对乙型肝炎病毒核心抗原呈抗体阳性（抗-HBc）。约一半被确认为抗-HBc阳性的吸毒者并不知道自己感染了肝炎。1992年抗-HIV-1流行率为7.0%，1993年为6.9%，显著较低。多变量分析显示，抗-HBc阳性在注射时间较长、有共用针头和注射器史的年长吸毒者中最为常见。HIV-1阳性也与共用注射设备史以及近期共用（即过去6个月内）有关。与抗-HBc阳性不同，HIV-1阳性与年龄或注射时间长短无关。注射时间较短的年轻吸毒者比注射时间较长的年长吸毒者更有可能报告近期共用过用过的注射设备。我们注意到乙肝病毒和HIV-1持续传播的可能性，尤其是在年轻吸毒者中。我们建议采取综合策略，以最大限度地保障吸毒者的健康，其中艾滋病毒和乙肝病毒预防是其中一部分。有必要扩大为乙肝病毒阴性的吸毒者及其性伴侣提供乙肝疫苗接种的范围，并为吸毒者提供关于漂白剂对乙肝病毒和艾滋病毒注射设备消毒相对功效的明确指导方针。
