Crofts N, Nigro L, Oman K, Stevenson E, Sherman J
Macfarlane Burnet Centre for Medical Research, Victoria, Australia.
Addiction. 1997 Aug;92(8):999-1005.
Harm reduction strategies for the prevention of transmission of human immunodeficiency virus (HIV) transmission among injecting drug users (IDUs) have been widely implemented in Australia and are seen to have been effective in preventing the spread of HIV. A major strategy has been increasing the availability of and accessibility to methadone maintenance therapy (MMT) programmes. We have reviewed the experience of a major MMT general practice with hepatitis C virus (HCV) infection from 1991 to 1995. Of 1741 individuals tested for HCV antibodies at least once 66.7% were positive. Of 73 IDUs who were initially seronegative and were retested at least once, 19 were subsequently seropositive. Seroconverters to HCV were younger than non-seroconverters, and were more likely to have evidence of previous hepatitis B infection. The overall HCV incidence rate was 22 cases per 100 person-years, and this did not differ between those on MMT programs (continuous or interrupted) between HCV tests and those not on MMT. These findings suggest that the role of MMT in the control of the spread of HCV infection among IDUs needs further assessment, and that control of the current epidemic of HCV infection among IDUs in Australia will be very difficult.
减少伤害策略用于预防注射吸毒者（IDU）之间的人类免疫缺陷病毒（HIV）传播，已在澳大利亚广泛实施，并被视为在预防HIV传播方面有效。一项主要策略是增加美沙酮维持治疗（MMT）项目的可及性和可获得性。我们回顾了1991年至1995年一家主要的MMT普通诊所中丙型肝炎病毒（HCV）感染的情况。在1741名至少接受过一次HCV抗体检测的个体中，66.7%呈阳性。在73名最初血清学阴性且至少接受过一次重新检测的IDU中，19名随后血清学呈阳性。转为HCV血清阳性的患者比未转为阳性的患者更年轻，且更有可能有既往乙型肝炎感染的证据。HCV总体发病率为每100人年22例，在两次HCV检测期间接受MMT项目（持续或中断）的患者与未接受MMT的患者之间无差异。这些发现表明，MMT在控制IDU中HCV感染传播方面的作用需要进一步评估，并且在澳大利亚控制IDU中当前的HCV感染流行将非常困难。
