VIRAL HEPATITIS IN CHILDREN OF INJECTION DRUG USERS

注射吸毒者儿童的病毒性肝炎

• 批准号: 6291234
• 负责人: KATHLEEN SCHWARZ
• 金额: $ 37.24万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-30 至 2004-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6291234
• 关键词: DVD /CD ROM; adolescence (12-20); adult human (21+); antibody titering; child (0-11); clinical research; computer assisted diagnosis; computer assisted instruction; education evaluation /planning; health education; hepatitis B; hepatitis C; hepatitis vaccine; homeless; human subject; immunization; intravenous drug abuse; longitudinal human study; noninvasive diagnosis; saliva; substance abuse epidemiology; vertical transmission

DESCRIPTION: (Applicant's Abstract) Hepatitis B virus (HBV) and hepatitis C virus (HCV) are endemic among adult injection drug users (IDUs). Children of IDUs (CIDU) are known to be at risk for HBV and HCV because of maternal-fetal transmission, and possibly, other factors as well. CIDU often live below the poverty level and - 1/3 of homeless children are CIDU. Although both poverty and the condition of being homeless are associated with low immunization rates, strategies to improve immunization for HBV in CIDU have not been systematically studied, and the epidemiology of HCV in this high-risk population has not been characterized. Therefore, the specific aims of this project are: 1) To develop a new multi-component intervention strategy (culturally adapted CD ROM-based educational materials, reminder systems, and clinic/shelter-based vaccines) to improve HBV immunization rates in CIDU and compare this strategy to conventional strategies 2) To characterize the epidemiology of HCV in CIDU. In Baltimore, we have identified three large cohorts of CIDU which are well-suited to accomplish the aims of this proposal: 1) 900 homeless children 2) 100 CIDU in the AIDS Linked to Intravenous Experience (ALIVE) study of adult IDUs and 3) 200 CIDU in the ongoing Risk, Evaluation and Assessment of Community Health (REACH) study of young IDUs. 1. In the immunization studies, we will partner with Hepatitis Foundation International (HFI) and Johns Hopkins Medical Video to adapt HFI educational materials about viral hepatitis to age- and culturally appropriate CDROM based presentations. Subjects will be randomized as to a "standard" or "special" prevention approach and ongoing critique and validation of the materials will be performed. 2. The epidemiologic studies in CIDU will include determination of HCV prevalence and will utilize an Automated Computer Assisted Self Interview to investigate injection drug use by parents and children, and other potential correlates of HCV infection among CIDU (e.g., tattooing, piercing). The novel approach of using a salivary anti-HCV (S-anti-HCV) assay for non-invasive screening in CIDU will be studied, after first validating the test in 60 children with chronic HCV infection. CIDU who test S-anti-HCV+ will have blood assayed for serologic markers for HCV, HBV, and human immunodeficiency virus. It has been estimated that complete eradication of hepatitis B and C infection from all children in the U.S. could save at least $200 million over the next 10 years, Preventative strategies emanating from this proposal could contribute significantly to reduction of both the high medical costs and human suffering secondary to these infections in children.

描述：（申请人摘要） 乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）在成人中流行 注射吸毒者 (IDU)。已知注射吸毒者 (CIDU) 的儿童面临风险 因母婴传播而导致的 HBV 和 HCV 感染，以及其他可能的感染 因素也。 CIDU 经常生活在贫困线以下 - 1/3 的无家可归者 孩子们是CIDU。尽管贫穷和无家可归的状况 与低免疫率、改善免疫接种的策略有关 CIDU中乙型肝炎病毒的流行病学尚未得到系统研究 该高危人群中的 HCV 尚未得到表征。因此， 该项目的具体目标是： 1）开发一种新的多组件 干预策略（基于文化的 CD ROM 教育材料， 提醒系统和诊所/庇护所疫苗）以改善乙型肝炎 CIDU 的免疫率并将该策略与传统策略进行比较 2) 描述 CIDU 中 HCV 的流行病学特征。在巴尔的摩，我们有 确定了 CIDU 的三大群体，它们非常适合完成 该提案的目标：1) 900 名无家可归的儿童 2) 100 名 CIDU 参与艾滋病相关活动 成人 IDU 的静脉注射经验 (ALIVE) 研究和 3) 200 CIDU 正在进行的社区健康风险、评价和评估 (REACH) 研究 年轻的注射吸毒者。 1. 在免疫研究方面，我们将与肝炎基金会合作 国际 (HFI) 和约翰·霍普金斯医疗视频适应 HFI 教育 有关病毒性肝炎的材料以适合年龄和文化的 CDROM 为基础 演示文稿。受试者将被随机分为“标准”或“特殊” 预防方法以及对材料的持续批评和验证将 被执行。 2. CIDU 的流行病学研究将包括确定 HCV 患病率并将利用自动计算机辅助自我 访谈调查家长和儿童注射吸毒情况等 CIDU 中 HCV 感染的潜在相关因素（例如纹身、穿孔）。 使用唾液抗 HCV（S-抗 HCV）检测的新方法 首先验证测试后，将研究 CIDU 中的无创筛查 60 名慢性 HCV 感染儿童。测试 S-抗 HCV+ 的 CIDU 将有 血液检测 HCV、HBV 和人类免疫缺陷的血清学标志物 病毒。 据估计，乙型和丙型肝炎感染将彻底根除 来自美国所有儿童的援助可以在未来 10 年节省至少 2 亿美元 年，该提案提出的预防性战略可能有助于 显着减少高昂的医疗费用和人类痛苦 继发于儿童的这些感染。