探討台灣海洛因依賴個案感染人類免疫缺乏病毒之危險因子

目的：針對台灣海洛因依賴個案，探究危險性行為和人類免疫缺乏病毒（HIV）感染的相關因子。本研究採用病例對照研究設計（case-controlstudy），共收集314位海洛因依賴個案，區分有HIV感染之海洛因依賴個案為病例組26位，並以沒有HIV感染之海洛因依賴個案為對照組288位，所有個案都會接受血液檢查有無B型肝炎、C型肝炎、梅毒，且分別取得人口學相關資料、危險性行為及海洛因使用狀況資料，和進行研究相關問卷之施測，再做基因分析，包括MAOA基因多型性、DRD4基因多型性及RANTES基因多型性。結果：在海洛因依賴個案，經過t檢定，顯示得到HIV感染的個案，其受教育年限較少（t = 2.014, p = .045），經過卡方檢定，顯示得到HIV感染的個案，其較無疾病史（X^2 = 11.187, p = .001），顯示得到HIV感染的個案，其與同性別有發生過性行為的比例較高（X2 = 7.409, p = .006），顯示得到HIV感染的個案，有共用針頭的比例較高（X^2 = 8.971, p = .003），顯示得到HIV感染的個案，有共用海洛因之稀釋水的比例較高（X62 = 10.079, p = .001）。DRD4基因多型性為long form，較容易得到HIV感染（X^2 = 9.443, p = .002）。經過Logistic regression，發現DRD4 long form（odds ratio: 10.468; p = .007）與RANTES基因的Haplotype有GGC（odds ratio: 31.712; p = .046）這兩者是造成海洛因依賴個案得到HIV感染的重要因子。討論：DRD4 long form會使得靜脈注射藥癮者有較高的比例去共用針頭（X^2 = 4.937, p = .026），進而有較高的機會去被人類免疫缺乏病毒所感染。

關鍵字

人類免疫缺乏病毒；海洛因依賴；危險性行為

並列摘要

Objective: Explore the related factors of sexual risk behaviors and HIV infection in Taiwan Heroin dependence subjects. Method: The study was a casecontrol study. We had collected 314 Heroin dependence subjects. Case group was Heroin dependence subjects with HIV infection (26 cases) and control group was Heroin dependence subjects without HIV infection (288 cases). Whole subjects had received blood examinations including Hepatitis B, Hepatitis C and syphilis and had completed demographic data, sexual risk behavior and heroin use conditions data. They also completed the study related questionnaire. We made gene typing analysis including MAOA gene polymorphism, DRD4 gene polymorphism and RANTES gene polymorphism. Result: In Heroin dependence subjects, after t-test, subjects with HIV infection had lower education level (t = 2.014, p = .045). After chi-square test, subjects with HIV infection had fewer history of medical disease (X^2 = 11.187, p = .001). Subjects with HIV infections had more sexual experience with the same gender (X^2 = 7.409, p = .006). Subjects with HIV infections had more needle sharing experience (X2 = 8.971, p = .003). Subjects with HIV infections had more dilution water sharing experience (X^2 = 10.079, p = .001). Subjects with DRD4 long form had higher risk to have HIV infection (X^2 = 9.443, p = .002). After logistic regression, we found that DRD4 long form and RANTES gene GGC haplotype were important factors to Heroin dependence subjects with HIV infection. Discussion: DRD4 long form subjects had higher ratio to experience needle sharing (X^2 = .937, p = .026). So maybe due to the reason, subjects with DRD4 long form had higher risk to suffer HIV infection.