社区医学之新挑战——物质滥用者艾滋病、B型肝炎及C型肝炎的高发病率  

The Rising Challenge of Community Medicine:High Prevalence of Human Immunodeficiency Virus,Hepatitis B and Hepatitis C Infections in Illicit Drug Users

作　　者：朱芳业 舒幸 江淑娟 

机构地区：[1]台湾

出　　处：《中国全科医学》2006年第13期1121-1121,共1页Chinese General Practice

摘　　要：目的 至2004年全球有2亿物质滥用者及13．2万静脉毒瘾者，据估计台湾有6万静脉毒瘾者，占成人人口的0．4％。在过去两年台湾被HIV感染的人数急剧增加，年新增感染人数倍增，其中60．0％为静脉毒瘾者，以至于在社区中诊治被感染病患的几率大大增加；另外两种血液传染疾病——B型及C型肝炎，在台湾亦是相当常见。本研究主要研究这些经血液传染疾病在静脉毒瘾者中的发病率。方法收集2005年2～9月在桃园某疗养院戒毒的患者。所有人皆接受HIV、B型肝炎病毒（HBV）、C型肝炎病毒（HCV）及梅毒血清检查。所有人皆取得其签署之同意书。结果 总共收案801人，其中36．0％（289人）为一级毒品（海洛因，古柯碱）滥用者，其余64．0％（512人）为二级毒品（安非他命，快乐丸）滥用者；34．2％（274人）有HCV感染，16．8％（135人）有HBV感染，7．6％（61人）有HIV感染。在289位静脉毒瘾者中，71．6％（207人）有HCV感染，Objective In 2004, there were 0. 2 billion of illicit drug users and 13. 2 million of injection drug users worldwide. The estimated number of injecting drug users （ IDU ） in Taiwan were about sixty thousand, i.e. 0.4% of adult population. There was dramatically increasing number of Human Immunodeficiency Virus （HIV） Infection in the last 2 years, with the number almost doubling per year, and injecting drug users accounted for 60. 0% of the new HIV cases. As a consequence, there was an increasing possibility of seeing patients with HIV infection in community. The other two blood - borne infections, namely hepatitis B and hepatitis C, are still also endemic in Taiwan. In order to better understand these blood - borne infectious diseases in injecting drug users, we have performed the following seroprevalence study. Methods From Feb 2005 to Sep 2005, consecutive persons with drug offenses who are incarcerated in Drug Treatment Center in a prison or who have visited the Drug Treatment Clinics in a mental hospital in Taoyuan were enrolled. All subjects underwent blood sampling for testing HIV Ab, HBV Ab, HCV Ab and STS after informed consents had been obtained. Results A total of 801 subjects were enrolled. Among them, 36.0% （ 289 patients） were class - 1 drug users （ heroin, cocaine） , and the others （64. 0% , 512 patients） were class - 2 drug users （ amphetamine, 3 - 4 methylenedioxymethamphetamine, i.e. MDMA ） .34. 2% （ 274 patients） have hepatitis C, 16. 8% （135 patients） have chronic hepatitis B, and 7. 6% （61 patients） have HIV infection. In the 289 patients who are IDU, the prevalence of HCV, HBV, or HIV is 71.6% （207 patients）, 17. 3% （50 patient）, or 17. 0% （49 patients） . In HIV- infected patients （61 patients）, 98.4% （60 patients） also have HCV infection, 14. 8% （9 patients） also have chronic hepatitis B, and 13. 1% （8 patients） have triple HIV, HBV, and HCV infections. 0. 4% （28 patients） of 801 patients have positive rapid reagin test for

关 键 词：B型肝炎病毒 C型肝炎病毒 社区医学 高发病率 滥用者 物质 艾滋病 静脉毒瘾者 HIV感染 HCV感染 

分 类 号：R512.6[医药卫生—内科学] R446.5[医药卫生—临床医学]