Hepatitis C Virus Intranasal Transmission: Pilot Study

丙型肝炎病毒鼻内传播：试点研究

• 批准号: 6947597
• 负责人: James M McMahon
• 金额: $ 15.92万
• 依托单位: NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-04-01 至 2007-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6947597
• 关键词: blood; chronic disease /disorder; clinical research; communicable disease transmission; data collection; disease /disorder proneness /risk; hepatitis C; hepatitis C virus; human subject; inhalation drug abuse; method development; pathology; patient oriented research; psychometrics; questionnaires; respiratory disorder diagnosis; virus RNA

Chronic active hepatitis C is a major health concern in the United States and worldwide. Hepatitis C virus (HCV) is primarily transmitted through contact with infected blood, with known risk factors including injection drug use, receipt of blood or blood products prior to 1992, tattoo and body piercing, and nosocomial exposure. Although much is known about HCV transmission, a substantial proportion of infected individuals report no identifiable source of exposure. Unexplained cases of HCV are particularly high among noninjection drug users, indicating a potential hidden source of infection within this group. One hypothesis to account for these unexplained cases is that HCV may be transmitted through contaminated sniffing/snorting implements, such as straws or spoons, shared by intranasal drug users. Snorted cocaine and other powdered drugs can irritate the nasal membranes causing deterioration, leakage and bleeding. When inserted into the nasal cavity, a sniffing implement may come into contact with HCV-infected nasal secretions or blood, which may then be transmitted to an uninfected individual sharing the same implement. Although several studies have shown intranasal drug use to be a significant risk factor for HCV infection, there is nearly a complete absence of virological, clinical, and behavioral data pertaining to this potential mode of HCV transmission. The proposed pilot study will help fill these research gaps by achieving the following specific aims: (i) develop reliable methods and perform laboratory assays to detect HCV RNA in the nasal secretions of plasma-positive intranasal drug users and on the surfaces of drug-sniffing implements; (ii) develop methods and perform assays to test for the presence of blood in nasal secretions and sniffing-implements, (iii) develop measures, collect preliminary data, and evaluate the psychometric properties of an instrument to assess risk factors that may be associate with intranasal HCV transmission; and (iv) develop and evaluate protocols for clinical examination and assessment of nasal cavity pathology among chronic drug-sniffers. While these aims focus on the development of new technologies and the collection of preliminary data for future research, the proposed study will, nonetheless, resolve several fundamental questions regarding the preconditions necessary for intranasal HCV transmission.

慢性活动性丙型肝炎是美国和全世界的主要健康问题。丙型肝炎病毒 (HCV) 主要通过接触受感染的血液传播，已知的危险因素包括注射毒品、1992 年之前接受血液或血液制品、纹身和身体穿孔以及医院内暴露。尽管人们对丙型肝炎病毒的传播了解很多，但相当一部分感染者报告没有可识别的暴露源。非注射吸毒者中不明原因的 HCV 病例特别多，表明该群体中存在潜在的隐藏感染源。解释这些无法解释的病例的一种假设是，丙型肝炎病毒可能通过鼻内吸毒者共用的受污染的嗅吸/吸食工具（例如吸管或勺子）传播。吸食可卡因和其他粉状药物会刺激鼻粘膜，导致鼻粘膜恶化、渗漏和出血。当插入鼻腔时，嗅探器可能会接触到 HCV 感染的鼻分泌物或血液，然后这些分泌物或血液可能会传播给共用同一嗅探器的未感染者。尽管一些研究表明鼻内用药是 HCV 感染的一个重要危险因素，但几乎完全缺乏与这种潜在 HCV 传播模式相关的病毒学、临床和行为数据。拟议的试点研究将通过实现以下具体目标来帮助填补这些研究空白：(i) 开发可靠的方法并进行实验室检测，以检测血浆阳性鼻内吸毒者的鼻分泌物和吸毒者表面上的 HCV RNA实施； (ii) 开发方法并进行测定，以测试鼻腔分泌物和嗅探工具中是否存在血液，(iii) 制定措施，收集初步数据，并评估仪器的心理测量特性，以评估可能与鼻腔分泌物相关的风险因素丙型肝炎病毒鼻内传播； (iv) 制定和评估长期吸毒者鼻腔病理学临床检查和评估方案。虽然这些目标侧重于新技术的开发和为未来研究收集初步数据，但拟议的研究将解决有关鼻内 HCV 传播所需先决条件的几个基本问​​题。