| 姚添,冯丹,潘明虎,程雁鹏,李春霞,王君,冯永亮,石璟,苏通,陈卿,石珊,王素萍.美沙酮维持治疗门诊受治者艾滋病病毒与丙型肝炎病毒共感染相关因素及交互作用分析[J].Chinese journal of Epidemiology,2018,39(5):631-635 |
| 美沙酮维持治疗门诊受治者艾滋病病毒与丙型肝炎病毒共感染相关因素及交互作用分析 |
| Related factors and interaction on HIV/HCV co-infection of patients access to methadone maintenance treatment |
| Received:October 20, 2017 |
| DOI：10.3760/cma.j.issn.0254-6450.2018.05.017 |
| KeyWord: 美沙酮维持治疗 艾滋病病毒与丙型肝炎病毒共感染 相关因素 交互作用 |
| English Key Word: Methadone maintenance treatment HIV/HCV co-infection Related factors Interaction |
| FundProject:国家科技重大专项（2012ZX10002001-003-004）；山西省回国留学人员科研资助（2013-056） |
| Author Name | Affiliation | E-mail | | Yao Tian | Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China | | | Feng Dan | Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China | | | Pan Minghu | Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China | | | Cheng Yanpeng | Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China | | | Li Chunxia | Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China | | | Wang Jun | Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China | | | Feng Yongliang | Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China | | | Shi Jing | Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China | | | Su Tong | Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China | | | Chen Qing | Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China | | | Shi Shan | Methadone Maintenance Treatment Clinic, Nanning Red Cross Hospital, Nanning 530012, China | | | Wang Suping | Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China | spwang88@163.com |
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| Abstract: |
| 目的 了解美沙酮维持治疗（MMT）门诊受治者HIV/HCV共感染情况，探讨HIV/HCV共感染的相关因素及交互作用。方法 2014年9－11月从广西壮族自治区2所MMT门诊招募MMT受治者750人，进行面对面问卷调查及查阅病例资料，收集一般人口学特征、HIV和HCV感染情况、既往吸毒史、吗啡尿检、高危性行为、共用针具、脱失等信息。采用EpiData 3.1软件和SAS 9.2软件进行数据录入和统计学分析，采用χ2检验单因素分析、logistic回归多因素分析和交互作用，分析HIV/HCV共感染的相关因素。结果 共调查MMT受治者691人，HIV/HCV共感染率为18.31%（127/691），共用针具者和MMT有脱失者的HIV/HCV共感染率分别为35.84%（81/226）和19.88%（64/322），均高于非共用针具者（9.89%，46/465）和MMT无脱失者（17.07%，63/369）。控制混杂因素后，共用针具者HIV/HCV共感染的风险是非共用针具者的4.50倍（95% CI：2.72～7.43），治疗期间有脱失者HIV/HCV共感染的风险较大（OR=1.71，95% CI：1.04～2.80）。共用针具和脱失存在相加交互作用（RERI=4.21，AP=0.44，SI=1.95），未发现相乘交互作用。结论 MMT受治者存在共用针具和脱失行为，均与HIV/HCV共感染具有明显的相关性，应加强健康教育、心理辅导等措施，减少共用针具和脱失行为。 |
| English Abstract: |
| Objective To estimate the prevalence of HIV/HCV co-infection and explore the influence factors and their interaction on HIV/HCV co-infection of patient's access to methadone maintenance treatment (MMT). Methods A face to face interviews were conducted among 750 patients at two MMT clinics in Guangxi Zhuang Autonomous Region. The questionnaires information included demographic characteristics, HIV and HCV infection status, history of drug abuse, urine test for morphine, high risk sex behaviors, needle sharing, dropped out etc. Methods of χ2 test one-way, multivariate logistic regression and interactions were used to analyze the related factors of HIV/HCV co-infection. Results The study subjects included 750 participants, 18.31% (127/691) of patients were co-infected with HIV and HCV. The HIV/HCV co-infection rate in patients who shared needles with others or dropped out of treatment was 35.84% (81/226) and 19.88% (64/322) respectively, which were higher than those who have never shared needles or dropped out (9.89%, 46/465 and 17.07%, 63/369). Logistic regression analysis results showed that after adjusted for confounding factors, patients who shared needles (OR=4.50, 95% CI:2.72-7.43) and dropped out of treatment (OR=1.71, 95% CI:1.04-2.80) were more likely to be infected with HIV/HCV. Interaction analysis showed that sharing needles and dropping out of treatment exist additive effect on co-infection of HIV and HCV (RERI=4.21, AP=0.44, SI=1.95). Conclusions Needle sharing and dropping out of treatment are associated with HIV/HCV co-infection. Health education, psychological counseling and other measures should be taken to reduce needle sharing and dropping out of MMT. |
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