社区注射吸毒人群前瞻性队列5年HIV和HCV新发感染研究

A five-year prospective cohort study of HIV/HCV infections in community-related injecting drug users

目的探索社区注射吸毒人群HIV和HCV发病率。方法自2014年6月至2019年6月,在云南省保山市隆阳区以当地的清洁针具交换点为平台,开展前瞻性队列研究,招募社区注射吸毒者200人作为研究对象。队列每6个月进行1次随访评估,调查高危吸毒行为和性行为情况,并采集血样进行HIV和HCV血清抗体检测。采用开放队列,每12个月队列开放1次,补充研究对象至200人。结果社区吸毒人群队列随访5年,共招募社区注射吸毒者231人,5年随访率为82.0%(164/200)。研究对象在研究期间第5年尚未发现HIV阳转。研究队列共有89名HCV阴性注射吸毒者,观察总人时为384.6人年,HCV发病率为0.26/100人年。结论该地区社区注射吸毒人群HIV和HCV发病率处于较低水平,需继续在吸毒人群中采取有效的综合性干预措施以控制该人群HIV传播。

Objective To explore incidences of HIV and HCV infections in injecting drug users(IDUs)in community.Methods A community-based survey was conducted to recruit 200 HIV sero-negative IDUs for a prospective cohort study based on the local needle and syringe exchange program in Longyang district of Baoshan city,Yunnan province from June 2014 to June 2019,China.Follow-up was carried out every six month to investigate the prevalence of drug use behavior and sexual behavior in IDUs.Blood samples were collected from them to test HIV and HCV serum antibodies.The cohort was opened for recvuitment every year to replenish the cohort to 200 subjects.Results A total of 231 IDUs were recruited after 5 years of follow-up.Cohort retention rate was 82.0%(164/200)in 5 years.No HIV sero-positive conversion was found during the 5-year study.There were 89 HCV negative IDUs.Totally,384.6 person years were observed and the HCV sero-positive conversion in this cohort was 0.26 per 100 person-years.Conclusion It was found that the incidences of HIV and HCV in IDUs in communities of the study area were at low levels,while comprehensive and effective intervention measures are still needed to control HIV and HCV infections in this population.