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Factors associated with needle sharing among people who inject drugs in Yunnan, China: a combined network and regression analysis

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Infectious Diseases of Poverty 2016年第1期5卷 660-669页

作者： Xin Chen Lin Zhu Yan-Heng Zhou Feng-Liang Liu Hong Li Zhi-Hong Yao Lin Duo Wei Pang Mei Ye Yong-Tang Zheng Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province Kunming Institute of ZoologyChinese Academy of SciencesKunmingYunnan 650223China Yunnan Center for Disease Control and Prevention KunmingYunnan 650022China The Second people’s Hospital of Yunnan Province KunmingYunnan 650021China Kunming College of Life Science University of Chinese Academy of SciencesKunmingYunnan 650204China College of Life Sciences Yan’an UniversityYan’anShaanxi 716000China

Background:Network analyses have been widely utilized to evaluate large datasets,but have not yet been used to explore factors associated with risk *** combination with traditional regression analysis,network analyses may provide useful information and highlight key factors for reducing needle sharing behaviours among people who inject drugs(PWID).Methods:Sociodemographic data,and information on injection behaviour and sexual practices were collected from a cross-sectional survey that was conducted with PWID in five prefectures of Yunnan province,China.A combination of logistic regression and correlation network analyses were used to explore key factors for reducing needle-sharing behaviours among ***:In a total of 1049 PWID,37.5%had a history of needle or syringe *** logistic analysis showed that Zhaotong,Qujing,Dehong,or Lincang residents,diazepam use,longer injection duration,needle reuse,and infection with HIV,viral hepatitis,tuberculosis and/or malaria were independently associated with needle *** correlation network analyses showed that,compared to PWID who had never shared needles,PWID who did share needles would achieve harm reduction goals faster and more *** serostatus and marital status were found to be closely associated with other risk *** combining regression analyses with network analyses,it was shown that PWID who are HIV seropositive will be an ideal target group for harm reduction ***:Needle-sharing behaviours are common among PWID in Yunnan,and harm reduction programs may help PWID who are HIV seropositive reduce risk behaviours and prevent blood borne diseases.

关键词： people who inject drugs Needle sharing Risk behaviours Network analysis Regression analysis China

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Clinicosocial Profile of people who inject drugs Receiving Opioid Substitution Therapy at New Delhi

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Journal of Forensic Science and Medicine 2023年第1期9卷 1-5页

作者： Alagarasan Naveen Shrabana Kumar Naik Dinesh Kataria Atul Murari Department of Forensic Medicine Lady Hardinge Medical College and Associated Hospitals Department of Forensic Medicine and Toxicology AIIMS BhubaneswarOdishaIndia Department of Psychiatry and Drug Deaddiction Centre Lady Hardinge Medical College and Associated HospitalsNew Delhi

Introduction:injecting drug use is a public health concern due to its clinical,social,economic,and legal ***:(1)To evaluate the prevalence of infections associated with injecting drug use;and(2)To assess the social profile of substance users and high-risk behaviors among people who inject drugs(PWID)receiving opioid substitution therapy(OST).Materials and Methods:A cross-sectional study was conducted among 100 PWID who were deemed eligible using inclusion and exclusion *** were collected through an interviewer-administered structured questionnaire after obtaining informed written ***:The results revealed that 14%of PWID had human immunodeficiency virus(HIV),7%had tuberculosis,and 2%had hepatitis B virus(HBV).None of the PWID self-reported hepatitis C virus(HCV)***,71%of PWID were living on the streets(***),and 41%of PWID had a history of sharing needles with other users in the preceding 3 *** or single PWID had significantly increased risk of homelessness(χ^(2)=4.570;P=0.032)and reported high-risk sexual practices with commercial sexual partners in the preceding 3 months(χ^(2)=4.163;P=0.041).Homeless PWID had significantly increased frequency of injecting practices(P=0.020).Conclusion:Despite the higher global prevalence of HCV compared with HBV and HIV among PWID,HCV testing is not currently conducted at most OST centers in *** to free needles and syringes should be enhanced to reduce the morbidity associated with injecting drug use.

关键词： Forensic psychiatry hepatitis human immunodeficiency virus opioid substitution therapy people who inject drugs risk of infection substance use

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HIV among people who inject drugs in Hungary

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Infectious Diseases of Poverty 2017年第1期6卷 1289-1293页

作者： Andras Ortutay VAnna Gyarmathy Zsuzsa Marjanek Karoly Nagy Jozsef Racz Istvan Barcs Anaesthesiology and Intensive Care Unit Javorszky Idon HospitalVácHungary Johns Hopkins Bloomberg School of Public Health BaltimoreMDUSA Faculty of General Medicine Institute of Medical MicrobiologySemmelweis UniversityBudapestHungary Institute of Psychology Eotvos Lorand UniversityBudapestHungary Faculty of Health Sciences Department of AddictologySemmelweis UniversityBudapestHungary Faculty of Health Sciences Department of EpidemiologySemmelweis UniversityBudapestHungary

Background:Before 2014(the year of closure of the two largest needle exchange programs in Hungary,which halved the number of available syringes in the country despite increased injecting risk practices)no HIV was reportedly acquired in Hungary among people who inject drugs(PWIDs)who were not also men who had sex with other men(MSM).In 2014,one and in 2015 two non-MSM PWIDs were newly diagnosed with HIV who supposedly became infected in Hungary,and both incident HIV cases in 2015 were diagnosed in the AIDS *** addition,two new(albeit supposedly imported)non-MSM PWID cases were also registered in the first three quarters of 2016,one of which subsequently was diagnosed with and then died of *** the same time,the prevalence of HCV doubled among PWIDs(from 24%to 49%in Hungary and from 34%to 61%in Budapest).Case presentation:The case that we discuss in this paper is a male PWID,who was diagnosed with HIV and AIDS in May of 2015 and then died of AIDS the next *** HIV infection status was detected with delay,and then appeared in the official statistics as an incident PWID HIV case and an incident PWID AIDS case,but not as an incident PWID AIDS *** contact tracing followed,even though it would have been relatively easy considering the *** our knowledge,no HIV post-exposure protocol exists in hospitals,in case of HIV exposure due to an eventual needle-stick ***:Our paper draws attention to recently published HIV and AIDS surveillance data,and shows the failure of the *** sounding the alarm based on three newly detected PWID HIV cases in the past 2 years may be premature,there are definitely serious problems in the HIV detection and tracing system among PWIDs in Hungary.

关键词： people who inject drugs HIV/AIDS Surveillance

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Real-world effectiveness of direct-acting antivirals in people living with human immunodeficiency virus and hepatitis C virus genotype 6 infections

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World Journal of Gastroenterology 2022年第11期28卷 1172-1183页

作者： Hsin-Yun Sun Chien-Yu Cheng Chi-Ying Lin Chia-Jui Yang Nan-Yao Lee Bo-Huang Liou Hung-Jen Tang Yuang-Meng Liu Chun-Yuan Lee Tun-Chieh Chen Yi-Chia Huang Yuan-Ti Lee Ming-Jui Tsai Po-Liang Lu Hung-Chin Tsai Ning-Chi Wang Tung-Che Hung Shu-Hsing Cheng Chien-Ching Hung Department of Internal Medicine National Taiwan University Hospital and National Taiwan University College of MedicineTaipei 100225TaiwanChina Department of Infectious Diseases Taoyuan General HospitalMinistry of Health and WelfareTaoyuan 330215TaiwanChina School of Public Health National Yang Ming Chiao Tung UniversityTaipei 112304TaiwanChina Department of Internal Medicine National Taiwan University Hospital Yun-Lin BranchYun-Lin County 640203TaiwanChina Department of Internal Medicine Far Eastern Memorial HospitalNew Taipei City 220216TaiwanChina School of Medicine National Yang Ming Chiao Tung UniversityTaipei 112304TaiwanChina Department of Medicine National Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainan 704302TaiwanChina Department of Internal Medicine Hsinchu MacKay Memorial HospitalHsin-Chu 300044TaiwanChina Department of Internal Medicine Chi Mei Medical CenterTainan 710402TaiwanChina Department of Health and Nutrition Chia Nan University of Pharmacy and SciencesTainan 717301TaiwanChina Department of Internal Medicine Changhua Christian HospitalChanghua 500209TaiwanChina Department of Internal Medicine Kaohsiung Medical University Hospital and College of MedicineKaohsiung Medical UniversityKaohsiung 807378TaiwanChina Department of Internal Medicine Kaohsiung Municipal Ta-Tung HospitalKaohsiung 801735TaiwanChina Department of Internal Medicine National Taiwan University Hospital Biomedical Park BranchHsin-Chu 302058TaiwanChina Department of Internal Medicine Chung Shan Medical University HospitalTaichung 402306TaiwanChina School of Medicine Chung Shan Medical UniversityTaichung 402306TaiwanChina Department of Internal Medicine Kaohsiung Medical University Hospital and College of MedicineKaohsiung Medical UniversityKaohsiung 807377TaiwanChina Department of Internal Medicine Kaohsiung Veterans General HospitalKaohsiung 813414TaiwanChina Department of Internal Medicine Tri-Service General HospitalNational Defen

BACKGROUND Hepatitis C virus(HCV)genotype 6(HCV-6)infection is prevalent predominantly in Southeast Asia,and the data on the virologic response of HCV-6 to direct-acting antivirals(DAAs)are sparse in people living with human immunodeficiency virus(HIV)(PLWH).AIM To assess the virologic response of HCV-6 to DAAs in *** From September 2016 to July 2019,PLWH coinfected with HCV-6 initiating DAAs were *** investigations were performed at baseline,the end of treatment,and 12 wk *** Of the 349 PLWH included(mean age 48.9 years,82.5%men),80.5%comprised people who inject drugs,18.1%men who have sex with men,and 1.4%*** hepatitis B virus infection was present in 12.3%of the included PLWH,liver cirrhosis 10.9%,hepatocellular carcinoma 0.9%,and previous HCV treatment experience 10.9%.The mean baseline plasma HCV RNA was 6.2 log10 IU/m *** with glecaprevir/pibrentasvir was initiated in 51.9%,sofosbuvir/ledipasvir 41.5%,sofosbuvir/velpatasvir 6.3%,and sofosbuvir/daclatasvir 0.3%.At DAA initiation,antiretroviral therapy containing tenofovir alafenamide was given in 26.4%,tenofovir disoproxil fumarate 34.4%,non-tenofovir alafenamide/tenofovir disoproxil fumarate 39.3%,non-nucleoside reverse-transcriptase inhibitors 30.4%,protease inhibitors 4.0%,and integrase strand transfer inhibitors 66.8%;94.8%of the included patients had CD4 counts≥200 cells/mm3 and 96.0%had plasma HIV RNA<50 copies/m ***,96.8%achieved undetectable plasma HCV RNA(<30 IU/m L)at end of treatment;and 92.3%achieved sustained virologic response 12 wk off-therapy in the intention-to-treat analysis(93.5%in patients receiving sofosbuvir-based DAAs and 91.2%in those receiving glecaprevir/pibrentasvir).CONCLUSION Similar to the observation made in HIV-negative patients,sustained virologic response 12 wk offtherapy with DAAs is high in PLWH coinfected with HCV-6.

关键词： Viral hepatitis End-of-treatment response Sustained virologic response people who inject drugs Antiretroviral therapy Tenofovir

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Outreach onsite treatment with a simplified pangenotypic directacting anti-viral regimen for hepatitis C virus micro-elimination in a prison

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World Journal of Gastroenterology 2022年第2期28卷 263-274页

作者： Chun-Ting Chen Ming-Ying Lu Meng-Hsuan Hsieh Pei-Chien Tsai Tsai-Yuan Hsieh Ming-Lun Yeh Ching-I Huang Yi-Shan Tsai Yu-Min Ko Ching-Chih Lin Kuan-Yu Chen Yu-Ju Wei Po-Yao Hsu Cheng-Ting Hsu Tyng-Yuan Jang Ta-Wei Liu Po-Cheng Liang Ming-Yen Hsieh Zu-Yau Lin Chung-Feng Huang Jee-Fu Huang Chia-Yen Dai Wan-Long Chuang Yu-Lueng Shih Ming-Lung Yu Division of Gastroenterology and Hepatology Department of Internal MedicineTri-Service General Hospital Penghu BranchNational Defense Medical CenterPenghu County 88041Taiwan Division of Gastroenterology and Hepatology Department of Internal MedicineTri-Service General HospitalNational Defense Medical CenterTaipei 11490Taiwan Division of Hepatobiliary Department of Internal Medicine and Hepatitis CenterKaohsiung Medical University HospitalKaohsiung 80708Taiwan School of Medicine and Hepatitis Research Center College of Medicineand Center for Liquid Biopsy and Cohort ResearchKaohsiung Medical UniversityKaohsiung 80708Taiwan National Pingtung University of Science and Technology Pingtung 912Taiwan

BACKGROUND Prisoners are at risk of hepatitis C virus(HCV)infection,especially among the people who inject drugs(PWID).We implemented an outreach strategy in combination with universal mass screening and immediate onsite treatment with a simplified pan-genotypic direct-acting antivirals(DAA)regimen,12 wk of sofosbuvir/velpatasvir,in a PWID-dominant prison in *** To implement an outreach strategy in combination with universal mass screening and immediate onsite treatment with a simplified pan-genotypic DAA regimen in a PWID-dominant prison in *** HCV-viremic patients were recruited for onsite treatment program for HCV micro-elimination with a pangenotypic DAA regimen,12 wk of sofosbuvir/velpatasvir,from two cohorts in Penghu Prison,either identified by mass screen or in outpatient clinics,in September *** group of HCV-viremic patients identified sporadically in outpatient clinics before mass screening were enrolled as a control *** primary endpoint was sustained virological response(SVR12,defined as undetectable HCV ribonucleic acid(RNA)12 wk after end-of-treatment).RESULTS A total of 212 HCV-viremic subjects were recruited for HCV micro-elimination campaign;91 patients treated with sofosbuvir/Ledipasvir or glecaprevir/pibrentasvir before mass screening were enrolled as a *** HCV microelimination group had significantly lower proportion of diabetes,hypertension,hyperlipidemia,advanced fibrosis and chronic kidney diseases,but higher levels of HCV *** SVR12 rate was comparable between the HCV microelimination and control groups,95.8%(203/212)vs 94.5%(86/91),respectively,in intent-to-treat analysis,and 100%(203/203)vs 98.9%(86/87),respectively,in perprotocol *** was no virological failure,treatment discontinuation,and serious adverse event among sofosbuvir/velpatasvir-treated patients in the HCV micro-elimination *** Outreach mass screening followed by immediate onsite treatment with a simplified pange

关键词： Direct-acting antivirals Sofosbuvir Velpatasvir people who inject drugs Universal screen

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New hope for hepatitis C virus:Summary of global epidemiologic changes and novel innovations over 20 years

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World Journal of Gastroenterology 2021年第29期27卷 4818-4830页

作者： Brittany B Dennis Leen Naji Yasmin Jajarmi Aijaz Ahmed Donghee Kim Department of Medicine McMaster UniversityHamilton L8S 4L8ONCanada Division of Gastroenterology and Hepatology Stanford University School of MedicineStanfordCA 94304United States Department of Family Medicine McMaster UniversityHamilton L8P 1H6ONCanada Department of Health Research Methods Evidence and ImpactMcMaster UniversityHamilton L8S 4K1ONCanada

Hepatitis C virus(HCV)is a global health concern associated with significant morbidity and *** the approval of second-generation direct-acting antiviral agents(DAAs),interferon therapy and liver transplantation constituted the mainstay of *** introduction of well-tolerated oral DAAs in late 2013 has revolutionized HCV management with over 95%cure *** predominance of HCV-related liver transplantations has declined following the widespread approval of *** the unparallel efficacy observed among these novel therapies,pharmaceutical costs continue to limit equitable access to healthcare and likely contribute to the differential HCV infection rates observed *** reduce the burden of disease worldwide,essential agenda items for all countries must include the prioritization of integrated care models and access to DAAs *** transparent negotiations with the pharmaceutical industry,the consideration for compassionate release of medications to promote equitable division of care is *** we provide a literature review of HCV,changes in epidemiologic trends,access issues for current therapies,and global inequities in disease burden.

关键词： Hepatitis C virus Direct-acting antivirals Global health Liver transplantation people who inject drugs Liver cirrhosis

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Dried blood spots,valid screening for viral hepatitis and human immunodeficiency virus in real-life

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World Journal of Gastroenterology 2016年第33期22卷 7604-7612页

作者： Belinda K Mossner Benjamin Staugaard Janne Jensen Soren Thue Lillevang Peer B Christensen Dorte Kinggaard Holm Department of Infectious Diseases Odense University Hospital Department of Medicine Lillebaelt Hospital Department of Clinical Immunology Odense University Hospital Department of Clinical Research University of Southern Denmark

AIM To detect chronic hepatitis B(CHB),chronic hepatitis C(CHC) and human immunodeficiency virus(HIV) infections in dried blood spot(DBS) and compare these samples to venous blood sampling in *** We included prospective patients with known viral infections from drug treatment centers,a prison and outpatient clinics and included blood donors as negative controls. Five drops of finger capillary blood were spotted on filter paper,and a venous blood sample was obtained. The samples were analyzed for HBs Ag,antiHBc,anti-HBs,anti-HCV,and anti-HIV levels as well as subjected to a combined nucleic acid test(NAT) for HBV DNA,HCV RNA and HIV *** Samples from 404 subjects were screened(85 CHB,116 CHC,114 HIV and 99 blood donors). DBS had a sensitivity of > 96% and a specificity of > 98% for the detection of all three infections. NAT testing did not improve sensitivity,but correctly classified 95% of the anti-HCV-positive patients with chronic and past infections. Anti-HBc and anti-HBS showed low sensitivity in DBS(68% and 42%).CONCLUSION DBS sampling,combined with an automated analysis system,is a feasible screening method to diagnose chronic viral hepatitis and HIV infections outside of the health care system.

关键词： Dried blood spot Real-life Screening Hepatitis B Hepatitis C Human immunodeficiency virus people who inject drugs Drug-users Prisoners

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