The HITS Study: Modes Of Transmission, Natural History And Determinants Of Outcome From Primary Hepatitis C Infection
Funder
National Health and Medical Research Council
Funding Amount
$948,250.00
Summary
Hepatitis C (HCV) affects approximately 200,000 Australians, of whom a significant minority develop long term complications, including cirrhosis, liver failure and liver cancer. The dominant mode of transmission of this virus is via blood-to-blood contact, particularly via injecting drug use. Prisons appear to be a key focus of transmission of hepatitis C in the community as the majority of inmates are incarcerated for drug-related crimes, and injecting drug use remains prevalent whilst in priso ....Hepatitis C (HCV) affects approximately 200,000 Australians, of whom a significant minority develop long term complications, including cirrhosis, liver failure and liver cancer. The dominant mode of transmission of this virus is via blood-to-blood contact, particularly via injecting drug use. Prisons appear to be a key focus of transmission of hepatitis C in the community as the majority of inmates are incarcerated for drug-related crimes, and injecting drug use remains prevalent whilst in prison. In addition, as almost one in two inmates are already infected at the time of incarceration, those who are uninfected appear to be at significant risk of becoming infected through other (non-injecting) routes such as tattooing, fights and other coincidental blood exposures. This application seeks support for the HITS study (Hepatitis C Incidence and Transmission in Prisons study) - a prospective cohort study of inmates of NSW prisons. Following a successful pilot in which the substantial bureaucratic and logistical hurdles were resolved, the main cohort has been enroling since late 2000. The initial data have confirmed a high rate of at risk behaviour amongst inmates and three primary HCV infections acquired in prison have been documented featuring an unusual antibody negative pattern which would typically pass undetected in screening assays for HCV infection. After exposure to HCV and the development of primary infection, approximately one in five individuals successfully resolves the infection and clears the virus, presumably via an efficient immune response or a non-virulent virus, or a combination of these factors. Therefore, in addition to the public health aspects of the HITS study, the research also aims to define the immunological and virological factors which allow clearance of HCV. These studies will provide key information to guide treatment and immunisation strategies against hepatitis C.Read moreRead less
Mortality In Young Offenders Who Have Had Custodial Sentences
Funder
National Health and Medical Research Council
Funding Amount
$60,448.00
Summary
The proposal seeks funding to investigate the death rate in young people who have received custodial sentences. There is evidence in the literature and anecdotal evidence from workers in the field that young offenders are at particularly high risk of dying from drug overdose, violently or by suicide, yet deaths in this group have not yet been investigated in Australia. As far as we are aware, there are also no reports worldwide of standardised mortality rates for young offenders who have been in ....The proposal seeks funding to investigate the death rate in young people who have received custodial sentences. There is evidence in the literature and anecdotal evidence from workers in the field that young offenders are at particularly high risk of dying from drug overdose, violently or by suicide, yet deaths in this group have not yet been investigated in Australia. As far as we are aware, there are also no reports worldwide of standardised mortality rates for young offenders who have been incarcerated. A group of young people who have received their first custodial sentences between 1988 and 1999 in Victoria will be identified, starting with 10 year olds in 1988. Their details will then be matched with data held by The National Death index, housed at the Australian Institute of Health and Welfare, and with the Victorian Coroner's data in order to identify deaths that have occurred, the cause of death and the circumstances of death. This will provide an index of the excess deaths experienced by this group of young offenders compared with Victorian population data for the same age group and gender. Further analysis will elucidate cause specific mortality, will enable the identification of subgroups at particular risk and the examination of trends over time. The study will provide a solid foundation for health priorities, the development of interventions and policy in relation to young offenders. It will provide a resource for Australasia and be of worldwide interest. Juvenile offenders are a well-defined group who has extended contact with support services. There is a unique opportunity for the delivery of interventions aimed at improving the welfare and adult outcomes of this enormously disadvantaged and marginalised section of our community. The Centre for Adolescent Health, as the auspicing body for the Adolescent Forensic Health Service is in an excellent position to respond to this challenge.Read moreRead less