丙型肝炎病毒感染主要危险因素的Meta分析

苏迎盈; 汪宁

Abstract

苏迎盈,汪宁.丙型肝炎病毒感染主要危险因素的Meta分析[J].Chinese journal of Epidemiology,2011,32(9):940-945

丙型肝炎病毒感染主要危险因素的Meta分析

Primary risk factors of hepatitis C virus infection: a Meta-analysis

Received:March 18, 2011

DOI：

KeyWord: 丙型肝炎危险因素 Meta分析

English Key Word: Hepatitis C Risk factOR Meta analysis

FundProject:国家“十一五”科技重大专项(2008ZX10001-003)

Author Name	Affiliation	E-mail
SU Ying-ying	National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
WANG Ning	National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China	wangnbj@163.Com

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Abstract:

目的分析丙型肝炎病毒(HCV)感染的危险因素。方法计算机检索中国医院知识仓库(CHKD)、万方数据知识平台、EBSCO、西文生物医学期刊文献服务系统、Elsevier，并结合文献追溯的方法，收集1994-2010年公开发表的关于HCV感染危险因素的文献，研究类型为病例对照研究或队列研究，采用RevMan 5.0及Stata 11.0软件对所选取的危险因素进行异质性检验、合并比值比(OR)及95％可信区间(CI)。结果共纳入25篇病例对照研究的文献，累计病例4370人、对照8606人。单因素分析合并的OR值及95％CI依次为：输血史4.23(2.82～6.35)、手术史2.13（1.70 ～ 2.67）、静脉注射吸毒史52.28(34.12～80.11)、性伴为静脉吸毒者7.19(3.13～16.51)、性病史3.43 (2.70 ～4.34)。多因素分析合并的OR值及95％CI为：输血史6.03(3.97 ～ 9.15)、手术史2.10(1.44～ 3.07)、静脉注射吸毒史44.90(31.13～64.76)、性伴为静脉吸毒者3.87(2.07～7.24)、性病史2.05(1.19 ～3.52)。结论HCV的危险因素为输血史、静脉注射吸毒史和性伴为静脉吸毒者；由于存在偏倚，还不能确定手术史是否为HCV感染的独立危险因素；性病史与HCV的感染呈弱相关，但结果不稳定，需要进一步研究。

English Abstract:

Objective To provide evidence for decision-making on primary hepatitis C prevention through analyzing the main risk factors of hepatitis C virus infection. Methods A comprehensive search was carried out in China Hospital Knowledge Database (CHKD), Wanfang Data, EBSCO, FMJS and Elsevier databases to identify all case-control and cohort studies published from 1994 to 2010 that evaluated the risk factors on the transmission of hepatitis C virus. Data manipulation and statistical analyses were performed using Stata 11.0 and RevMan 5.0 softwares.Results A total of 25 case-control studies were included in this Meta-analysis, which contained 4370 cases and 8606 controls. In univariate analysis, the pooled odds ratio (OR) and 95％ confidence interval (CI) on the risk factors associated with HCV seropositivity were "blood transfusion" 4.23 (2.82-6.35), "having had surgical operations" 2.13 (1.70-2.67), "intravenous drug use" 52.28(34.12-80.11 ), "having sex with intravenous drug users" 7.19 ( 3.13- 16.51 ), "histories of having had STDs" 3.43 (2.70-4.34). In multivariate analysis, pooled OR and 95％CI of the risk factors associated with HCV seropositivity were: having had following "histories as blood transfusion" 6.03 (3.97-9.15), "surgeries" 2.10( 1.44-3.07), "intravenous drug use" 44.90(31.13-64.76), "having sex with intravenous drug users" 3.87(2.07-7.24), "having STDs" 2.05(1.19-3.52).Conclusion Blood transfusion、 intravenous drug use and having sex with intravenous drug users were the risk factors of HCV infection. Due to existing biases, the relationship between having had surgical operations and HCV infection was inconclusive. There appeared weak correlation between STDs and HCV infection,but the result was not so stability.

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