Lancet Global Health:为何全球HIV及丙肝感染的控制如此令人担忧?

2017-10-25 枫丹白露 来宝网

对注射毒品使用的全球流行情况和注射毒品人群中血源性病毒传播的干预措施的评论,令人担忧。

吸毒者中艾滋病与肝炎风险的新视觉】对注射毒品使用的全球流行情况和注射毒品人群中血源性病毒传播的干预措施的评论,令人担忧。

在世界各地许多国家提供防止艾滋病毒和肝炎蔓延的方案是不够的,并且呈现出严重的公共卫生问题,澳大利亚国家药物和酒精研究中心的研究人员进行了全面审查。

注射毒品使用的全球流行率和预防PWID中血源性病毒传播的干预措施的两个评论今天在国际领先的“柳叶刀全球健康”杂志上发表。

作者估计,最近有1560万人注射毒品。其中18%的人感染艾滋病毒,52%的人感染丙型肝炎(HCV)抗体

作者发现,尽管证据显示针和注射器方案(NSP)和阿片类药物替代疗法(OST)可以减少艾滋病毒和HCV感染,但是在许多地方仍然没有实施,很少有人可以在许多国家使用它们。

澳大利亚是全球仅有的四个国家之一,涵盖了NSP和OST,其他国家则有奥地利,荷兰和挪威。

在澳大利亚,百分之一百的PWID患有艾滋病毒,东欧的PWID为百分之二十五,拉丁美洲为百分之三十六,撒哈拉以南非洲为百分之十八,南亚为百分之九十九。

相比之下,PWID中丙型肝炎的流行程度更加均匀地扩散 - 在澳大利亚和新西兰注射毒品的人中有57%对丙型肝炎抗体检测阳性,而中欧为64%,北美为55%,北美为50%在东亚和东南亚的百分比。

联合国开发计划署的路易莎·德根哈特教授说,在所有国家,大量注射毒品的人都患有艾滋病毒或丙型肝炎病毒,并且暴露于增加健康危害的多个不利风险环境。

注射毒品使用的全球流行评估和预防血源性病毒扩散的方案的评估是自2008年以来首次进行的评估,尽管由于不同和更复杂的数据收集技术,结果不能直接比较。

与上次审查相比,在33个国家中发现注射吸毒的证据 - 主要来自撒哈拉以南非洲地区。

有超过一半(52%)有注射毒品证据的国家有针头和注射器方案。在所有确定的国家(48%)中,不到一半的国家提供了用于鼓励减少阿片类药物替代疗法的药物治疗。

关于干预措施全球覆盖的论文的主要作者,联合国世界卫生大会的主席Sarah Larney博士说:“针对PWID的艾滋病毒和丙型肝炎预防干预措施的覆盖率仍然很差,可能不足以有效预防艾滋病毒和丙型肝炎病毒传播。扩大干预措施仍然是阻止艾滋病毒和HCV流行病的关键优先事项。

“单独出现干预措施是不够的,当NSP和OST在高覆盖范围和组合下实施时,报告最大的预防效果,”Larney博士补充说。

全球三个注射毒品人口最多的地区,东亚,东南亚,东欧和北美地区,针刺方案和阿片样物质替代疗法供应不足。

这些国家的艾滋病毒流行率很高,从北美的9%增加到东欧的25%。相比之下,在澳大利亚和新西兰注射毒品的人中只有1%患有艾滋病毒。

作者说:“这些地区的几个国家经历了最近的艾滋病毒暴发以及PWID持续高HCV感染率。

作者发现,例如,俄罗斯有近二百万人注射毒品,近30%的艾滋病毒感染者和69%的丙型肝炎患者不被提供OST,而且非常有限。

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    2018-07-26 shizhenshan
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    2018-01-27 howi
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    2017-10-25 1dd8c52fm63(暂无匿称)

    学习学习.了解了解

    0

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    2017-10-25 清风拂面

    很好的文章.学习受益匪浅

    0

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    2017-10-25 中医痴

    不错的.学习了.谢谢分享!

    0

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