HCV Transmission among Young IDUs in NYC

纽约市年轻注射吸毒者中的丙型肝炎病毒传播

• 批准号: 7851296
• 负责人: BRIAN R. EDLIN
• 金额: $ 83.41万
• 依托单位: SUNY DOWNSTATE MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-06-01 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7851296
• 关键词: Accounting; Acute Hepatitis C; Affect; Behavior; Biological Assay; Blood; Cause of Death; Cessation of life; Communities; Computers; Cutaneous; Data; Development; Doctor of Medicine; Dose; Epidemic; Epidemiology; Equipment; Event; Funding; HIV; Hepatitis C; Hepatitis C Transmission; Hepatitis C virus; Immune response; Immunity; Incidence; Infection; Injecting drug user; Injection of therapeutic agent; Intervention; Interview; Interviewer; Measurement; Methods; Modeling; Needle Sharing; Nucleic Acids; Opportunistic Infections; Participant; Performance; Persons; Pharmaceutical Preparations; Preparation; Prevention; Preventive Intervention; Recruitment Activity; Relative (related person); Research; Research Personnel; Risk; Risk Behaviors; Running; Shares syringes; Side; Source; Surface; Syringes; Testing; Virus Diseases; Visit; Water; cohort; community intervention; contextual factors; evidence base; falls; follow-up; high risk; premature; protective effect; response; transmission process; viral RNA

DESCRIPTION (provided by applicant): The purpose of this study is to determine the risks of acquiring hepatitis C virus (HCV) infection associated with specific injection practices in a cohort of young, high-risk injection drug users (IDUs) on the Lower East Side of Manhattan, and the possible protective effect of pre-existing HCV-specific immune responses. Hepatitis C is the most rapidly rising opportunistic infection in persons with human immunodeficiency virus (HIV) infection and already the leading cause of death in persons with HIV/HCV co-infection. Because it is more prevalent and more readily transmitted among IDUs than HIV, HCV prevention serves as a sensitive model for the prevention of HIV and other bloodborne infections among IDUs. Despite advances in our understanding of HCV and its transmission, HCV continues to spread rapidly among IDUs, who now account for most new HCV infections in the developed world. A better understanding of the risks associated with the sharing of syringes and other injection equipment and many other opportunities for blood contact that arise during the preparation and injection of drugs is needed to guide the development of more effective prevention interventions. The proposed study will interview 100 high-risk, HCV-uninfected IDUs every two weeks and collect detailed information about their injection practices in order to examine the risks associated with specific injection practices. The specific aims are to: (1) Determine the specific injection practices associated with an increased risk of HCV infection, and estimate for each (a) the magnitude of the risk, (b) the dose-response relationship, and (c) the per-act transmission rate; (2) Examine how a prolonged period of frequent interaction with a research interviewer affects the relative performance of interviewer- vs. computer- administered questions; (3) Examine the impact of certain contextual factors characterizing injection settings on injection practices and HCV transmission; and (4) 4. Examine whether HCV-specific cellular immune responses observed in subjects at baseline exert a protective effect, and estimate the strength of any such effect. The findings from this study will help guide the development of evidence-based HCV prevention interventions, permit more accurate modeling of the HCV epidemic, and enhance our understanding of HCV- specific immunity.

描述（由申请人提供）：本研究的目的是确定下东地区年轻高危注射吸毒者 (IDU) 群体中与特定注射行为相关的丙型肝炎病毒 (HCV) 感染风险曼哈顿一侧，以及预先存在的 HCV 特异性免疫反应的可能保护作用。丙型肝炎是人类免疫缺陷病毒 (HIV) 感染者中增长最快的机会性感染，并且已经成为 HIV/HCV 混合感染者死亡的主要原因。由于丙型肝炎病毒在注射吸毒者中比艾滋病毒更普遍且更容易传播，因此预防丙型肝炎病毒可作为预防注射吸毒者中艾滋病毒和其他血源性感染的敏感模型。尽管我们对丙型肝炎病毒及其传播的了解有所进展，但丙型肝炎病毒继续在注射吸毒者中迅速传播，目前发达国家中大多数新发丙型肝炎病毒感染者都是注射吸毒者。需要更好地了解与共用注射器和其他注射设备相关的风险以及在药物制备和注射过程中出现的许多其他血液接触机会，以指导制定更有效的预防干预措施。拟议的研究将每两周采访 100 名未感染 HCV 的高风险注射吸毒者，并收集有关他们注射行为的详细信息，以检查与特定注射行为相关的风险。具体目标是：(1) 确定与 HCV 感染风险增加相关的具体注射做法，并估计每个 (a) 风险的大小、(b) 剂量反应关系和 (c)每动作传输率； (2) 检查与研究访谈员长时间频繁互动如何影响访谈员提问与计算机提问的相对表现； (3) 检查注射设置的某些背景因素对注射实践和 HCV 传播的影响； (4) 4. 检查基线时在受试者中观察到的 HCV 特异性细胞免疫反应是否发挥保护作用，并估计任何此类作用的强度。这项研究的结果将有助于指导基于证据的 HCV 预防干预措施的制定，允许更准确地建立 HCV 流行模型，并增强我们对 HCV 特异性免疫的理解。