中华流行病学杂志  2014, Vol. 35 Issue (11): 1212-1217   PDF    
http://dx.doi.org/10.3760/cma.j.issn.0254-6450.2014.11.008
中华医学会主办。
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文章信息

许可, 朱立国, 汤奋扬, 鲍倡俊, 朱叶飞, 曹民权, 杜国民, 徐建芳, 彭红, 翟祥军. 2014.
Xu Ke, Zhu Liguo, Tang Fenyang, Bao Changjun, Zhu Yefei, Cao Minquan , Du Guomin, Xu Jianfang, Peng Hong, Zhai Xiangjun. 2014.
江苏省部分地区人群丙型肝炎病毒感染状况及危险因素研究
Rate of infection and related risk factors on hepatitis C virus in three counties of Jiangsu province
中华流行病学杂志, 2014, 35(11): 1212-1217
Chinese Journal of Epidemiology, 2014, 35(11): 1212-1217
http://dx.doi.org/10.3760/cma.j.issn.0254-6450.2014.11.008

文章历史

投稿日期:2014-6-24
江苏省部分地区人群丙型肝炎病毒感染状况及危险因素研究
许可1, 朱立国2, 汤奋扬1, 鲍倡俊1, 朱叶飞1, 曹民权3, 杜国民4, 徐建芳5, 彭红2, 翟祥军1,2     
1 210009 南京, 江苏省疾病预防控制中心急性传染病防制所;
2 210009 南京, 江苏省疾病预防控制中心重大项目办公室;
3 泰兴市疾病预防控制中心重大项目办公室;
4 张家港市疾病预防控制中心重大项目办公室;
5 丹阳市疾病预防控制中心
摘要目的 调查江苏省一般人群HCV抗体的阳性率分布,分析感染HCV的危险因素。方法 在江苏省3个地区的传染病防制示范区以乡镇和行政村为单位随机整群抽样,进行问卷调查和血清HCV抗体检测,利用SPSS软件分析抗体阳性率在不同人群中的分布差异,Cox模型拟合1:4配对的logistic回归分析HCV感染危险因素。结果 HCV感染情况在不同人群分布有差异,女性感染率(0.965%,95%CI:0.899%~1.035%)高于男性(0.572%,95%CI:0.517%~0.632%);3个县人群感染率(分别为0.131%,95%CI:0.103%~0.164%;0.316%,95%CI:0.268%~0.370%;2.173%,95%CI:2.039%~2.315%)的差异有统计学意义;50~59岁年龄组感染率最高(1.577%,95%CI:1.425%~1.740%),<30岁年龄组最低(0.161%,95%CI:0.125%~0.204%); 受教育程度越低感染率越高,其中流动人口感染率高。危险因素分析显示,感染率最低的地区多因素分析显示住院史(OR=3.049,95%CI:1.322~7.036)、输血史(OR=14.319,95%CI:2.318~88.459)和共用剃刀(OR=3.604,95%CI:1.096~11.851)是HCV感染的独有危险因素;感染率较低的地区分析显示仅血制品使用史(OR=7.202,95%CI:1.170~44.310)是独有危险因素;感染率最高的地区显示献血史(OR=7.496,95%CI:6.121~9.180)、输血史(OR=2.305,95%CI:1.578~3.369)和侵入性检查史(OR=1.258,95%CI:1.021~1.549)为独立危险因素。不同年龄组单因素分析显示,30~39岁组与他人共用剃刀是独有危险因素,50~59岁组有针灸史是该年龄组危险因素,50~59岁和60~69岁组有侵入性检查是危险因素。结论 HCV感染在中老年人、教育程度低、流动性强的人群中感染率高,不安全献(输)血、血制品使用可能是既往几十年中HCV感染的主要危险因素;针灸、侵入性检查以及共用剃刀等在不同人群中的危险度有差异。
关键词丙型肝炎病毒     危险因素     病例对照研究    
Rate of infection and related risk factors on hepatitis C virus in three counties of Jiangsu province
Xu Ke1, Zhu Liguo2, Tang Fenyang1, Bao Changjun1, Zhu Yefei1, Cao Minquan3, Du Guomin4, Xu Jianfang5, Peng Hong2, Zhai Xiangjun1,2     
1 Department of Acute Infectious Disease Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210009, China;
2 Department of the National Major Science and Technology Projects, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210009, China;
3 Department of the National Major Science and Technology Projects, Taixing Center for Disease Prevention and Control;
4 Department of the National Major Science and Technology Projects, Zhangjiagang Center for Disease Prevention and Control;
5 Department of Acute Infectious Disease Prevention and Control, Danyang Center for Disease Prevention and Control
Abstract: Objective To investigate the hepatitis C virus(HCV) infection rate among general population in Jiangsu province and to analyze the main risk factors for HCV infection. Methods Subjects in 3 counties were surveyed by stratified cluster random sampling in the National Major Science and Technology Projects demonstration area in Jiangsu province. Interview was carried out with uniformly-designed questionnaires. Blood samples were collected and anti-HCV tested. Data were analysed under SPSS 13.0. Case-control study was conducted on two groups with subjects under 1:4 matching by sex,age,village of residence and status of HCV infection. Cox's proportional hazards regression analysis was then performed to analyze the risk factors for HCV infection. Results The positive rate of anti-HCV was higher in females (0.965%,95%CI:0.899%-1.035%) than in males (0.572%,95%CI:0.517%-0.632%). Significant differences were noticed among the positive rates of anti-HCV in the three counties (0.131%,95%CI:0.103%-0.164%;0.316%,95%CI:0.268%-0.370%;2.173%,95%CI:2.039%-2.315%,respectively). Peak prevalence of anti-HCV (1.577%, 95%CI:1.425%-1.740%) was observed among persons at 50-59 years of age. Bottom rate (0.161%,95%CI:0.125%-0.204%) was observed below 30 years of age. High anti-HCV positive rate was detected in people with lower education background or belonged to ‘floating population'. Factors as having histories of hospitalization (OR=3.049,95%CI:1.322-7.036),blood transfusion (OR=14.319,95%CI:2.318-88.459) or sharing razor (OR=3.604,95%CI:1.096-11.851) were risk factors of HCV infection in the area with the lowest anti-HCV positive rate. In another county,factor as having histories of ‘blood products transfusion'(OR=7.202,95%CI:1.170-44.310) appeared important while in the third county,having history of ‘blood donation' (OR=7.496,95%CI:6.121-9.180);‘blood transfusion'(OR=2.305,95%CI:1.578-3.369) and ‘invasive physical examination' (OR=1.258,95%CI:1.021-1.549) appeared to be important. Age seemed a risk factor for HCV infection. "Sharing razor" was a specifically important risk factor among the 30-year-olds. "Having received acupuncture" was noticed a risk factor only among people at 50-59 years of age while "Having received invasive physical examination" was important in the 50-59 and 60-69 year-olds. Conclusion High anti-HCV positive rate was observed in people at middle of aged population,as well as in those with poor education or under ‘floating'. Unsafe blood donation or having received blood-product transfusion might be the risk factors in the last decades. Factors as sharing razor,having received acupuncture or invasive examination might be specifically risky in different populations.
Key words: Hepat