Malliori M, Sypsa V, Psichogiou M, Touloumi G, Skoutelis A, Tassopoulos N, Hatzakis A, Stefanis C
Department of Psychiatry, University of Athens, Greece.
Addiction. 1998 Feb;93(2):243-51. doi: 10.1046/j.1360-0443.1998.9322438.x.
To determine HIV and hepatitis infection prevalence and correlates with risk behaviour.
Cross-sectional study: voluntary, anonymous HIV, hepatitis (HCV, HBV and HDV) surveillance and questionnaire on risk factors.
Korydallos Prison, Athens and Ag. Stefanos Prison, Patra, Greece.
Of 544 drug users imprisoned for drug related offences, all completed the questionnaire and 533 blood samples were collected.
HIV (by anti-HIV-1), HCV (by anti-HCV), HBV (by anti-HBc, HBsAg) and HDV (by anti-HDV) prevalence. Data on demography, legal status, drug use, sharing of injecting equipment.
Of the 544 drug users, 375 (68.9%) had injected drugs (IDUs) at some time, 35% of whom had injected whilst in that prison. Of the 533 blood samples tested, one was positive for anti-HIV-1 (0.19%), 310 for anti-HCV (58.2%), 306/531 (57.6%) for anti-HBc, 34/527 (6.5%) for HBsAg and 12/527 (2.3%) for anti-HDV. Prevalence rates for IDUs only were 0.27% for HIV-1, 80.6% for hepatitis C, 62.7% for hepatitis B and 3.3% for hepatitis D. Ninety-two per cent of IDUs injecting in prison shared needles, indicating that IDUs inject less but share more during incarceration. Multiple logistic regression revealed needle-sharing as the most important risk factor for HCV infection in IDUs. Prior knowledge of a positive hepatitis result did not appear to inhibit IDUs from practising risky behaviours in prison.
The epidemic of hepatitis B and C among imprisoned IDUs identified by this study constitutes a major public health problem. Prevention programmes, such as counselling, HBV vaccination, community-based methadone maintenance treatment and syringe exchange schemes, are necessary in order to prevent a further spread.
确定艾滋病毒和肝炎感染率及其与危险行为的关联。
横断面研究：自愿、匿名的艾滋病毒、肝炎（丙型肝炎病毒、乙型肝炎病毒和丁型肝炎病毒）监测以及关于危险因素的问卷调查。
希腊雅典的科里达洛斯监狱和帕特雷市的圣斯特凡诺斯监狱。
544名因与毒品相关罪行入狱的吸毒者，均完成问卷调查，共采集533份血样。
艾滋病毒（通过抗HIV-1检测）、丙型肝炎病毒（通过抗HCV检测）、乙型肝炎病毒（通过抗HBc、HBsAg检测）和丁型肝炎病毒（通过抗HDV检测）感染率。人口统计学、法律状况、吸毒情况、注射器具共用情况的数据。
在544名吸毒者中，375人（68.9%）曾有过注射吸毒行为（注射吸毒者），其中35%是在该监狱服刑期间注射的。在检测的533份血样中，1份抗HIV-1呈阳性（0.19%），310份抗HCV呈阳性（58.2%），531份中有306份（57.6%）抗HBc呈阳性，527份中有34份（6.5%）HBsAg呈阳性，527份中有12份（2.3%）抗HDV呈阳性。仅针对注射吸毒者的感染率为：艾滋病毒-1为0.27%，丙型肝炎为80.6%，乙型肝炎为62.7%，丁型肝炎为3.3%。在监狱中注射的注射吸毒者中有92%共用针头，这表明注射吸毒者在监禁期间注射次数减少但共用针头的情况增多。多因素逻辑回归显示，共用针头是注射吸毒者感染丙型肝炎病毒的最重要危险因素。对肝炎检测呈阳性结果的事先知晓似乎并未阻止注射吸毒者在监狱中实施危险行为。
本研究确定的被监禁注射吸毒者中乙型和丙型肝炎流行构成一个重大公共卫生问题。为防止进一步传播，需要开展预防项目，如咨询、乙型肝炎疫苗接种、社区美沙酮维持治疗和注射器交换计划。
