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在监狱环境中感染型肝炎病毒的发生率:SToP-C研究
Behzad Hajarizadeh1, Joanne M Carson1, Marianne Byrne1
1The Kirby Institute, University of New Soth Wales (UNSW), Sydney, New South Wales, Australia.
Journal of viral hepatitis
|November 8, 2023
概括
型肝炎病毒 (HCV) 感染在监狱中注射毒品的人群中迅速传播. 高剂量阿片类药激素治疗 (OAT) 显著降低了HCV风险,突出了扩大OAT和减少危害计划的需要.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 由于普遍使用注射毒品,监狱中的囚犯面临着感染C型肝炎病毒 (HCV) 的高风险.
- 了解监狱内的HCV发病率和传播动态对于有针对性的干预至关重要.
研究的目的:
- 评估HCV感染的发病率,并确定监禁人员中注射药物使用的相关特征.
- 评估阿片类药物激素治疗 (OAT) 和针/注射器共享实践对监狱中HCV风险的影响.
主要方法:
- 在SToP-C研究中,从2014年10月到2019年11月,在澳大利亚四个监狱招募了1643名参与者.
- 在入学时和每3-6个月进行一次HCV检测;分析包括有初级或再感染风险的个人.
- 使用统计分析,包括调整后的危险比率 (aHR),来确定HCV传播的风险因素.
主要成果:
- 总体HCV发病率为6.11/100人年,再感染的发病率 (9.34) 比原发感染的发病率 (4.60) 高.
- 在监狱内注射毒品 (aHR: 10.55) 和释放/重新监禁 (aHR: 1.60) 显著增加了HCV风险.
- 高剂量的OAT (甲≥60mg/天或布普伦诺芬≥16mg/天) 降低了HCV风险 (aHR:0.11),而共用针/注射器增加了风险 (HR:4.60).
结论:
- 在惩戒设施内存在大量的HCV传播风险,特别是在注射毒品的人群中.
- 高剂量的OAT在这个人群中显示出对HCV感染的保护作用.
- 改善OAT覆盖和针/注射器计划对于减轻监狱中HCV传播至关重要.
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