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; 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

Abstract

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.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[J].Chinese journal of Epidemiology,2014,35(11):1212-1217

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

Received:June 24, 2014

DOI：10.3760/cma.j.issn.0254-6450.2014.11.008

KeyWord: 丙型肝炎病毒危险因素病例对照研究

English Key Word: Hepatitis C virus Risk factors Case-control study

FundProject:国家科技重大专项(2011ZX10004-902);江苏省自然科学基金(BK2011840)

Author Name	Affiliation	E-mail
Xu Ke	Department of Acute Infectious Disease Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210009, China
Zhu Liguo	Department of the National Major Science and Technology Projects, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210009, China
Tang Fenyang	Department of Acute Infectious Disease Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210009, China
Bao Changjun	Department of Acute Infectious Disease Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210009, China
Zhu Yefei	Department of Acute Infectious Disease Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210009, China
Cao Minquan	Department of the National Major Science and Technology Projects, Taixing Center for Disease Prevention and Control
Du Guomin	Department of the National Major Science and Technology Projects, Zhangjiagang Center for Disease Prevention and Control
Xu Jianfang	Department of Acute Infectious Disease Prevention and Control, Danyang Center for Disease Prevention and Control
Peng Hong	Department of the National Major Science and Technology Projects, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210009, China
Zhai Xiangjun	Department of Acute Infectious Disease Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210009, China Department of the National Major Science and Technology Projects, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210009, China	jszxj@jscdc.cn

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Abstract:

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。

English 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.

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