上海市浦东新区丙型肝炎病毒感染者基因分型与危险因素分析  

Study on genotyping and risk factors of hepatitis C virus infection in new area of pudong

作　　者：吴红岩[1] 陆一涵[2] 朱渭萍[1] 储强[1] 马平[1] 李盛[1] 姜庆五[2] 

机构地区：[1]上海市浦东新区疾病预防控制中心,上海200136 [2]复旦大学公共卫生学院公共卫生安全教育部重点实验室

出　　处：《中国预防医学杂志》2012年第11期839-843,共5页Chinese Preventive Medicine

基　　金：上海市浦东新区社会发展局卫生科技项目(PW2008A-23);复旦大学新教师科研启动基金(10FX052)

摘　　要：目的了解上海市浦东新区丙型肝炎病毒(HCV)基因分型现状,掌握HCV感染的主要危险因素。方法采用病例对照研究的方法,通过问卷调查分析浦东新区2008-2009年报告的109例HCV感染者(病例组)和109例健康者(对照组)的危险因素,同时利用巢式RT-PCR检测血清HCV RNA,并进行基因分型,最后比较各基因亚型的社会人口学特征和感染危险因素。结果病例组与对照组的职业和文化程度构成显著不同。多因素logistic回归分析显示,输血/血制品使用史(OR=13.97)、创伤性美容史(OR=4.03)和修面/刮胡须史(OR=4.72)是HCV感染的可能危险因素。病例组患者血清HCV RNA检出率为63.83%(60/94),以1b亚型(51.67%)和2a亚型(15.00%)为主;但同时存在1a、3a、3b、6a、6n亚型。其中,1b和2a亚型的感染者年龄较高,且退休人员的比例较高。各亚型患者间,仅创伤性美容史的分布有差异。结论输血/血制品使用、创伤性美容和修面/刮胡须是浦东新区HCV感染的主要危险因素。本地区HCV基因型仍以1b/2a亚型为主,但其他亚型并存,且各亚型的流行特征存在一定差别。Objective To understand the genotyping status and explore the risk factors of HCV infection in Pu- dong New Area. Methods A case-control study was conducted with 109 HCV patients and 109 health con- trols in 2008-2009 for the determination of risk factors. Genotypes were identified by nested RT PCR and then demographics and risk factors were analyzed and compared. Results The occupations and education degrees of HCV patients were significantly different compared with controls. Multivariate unconditional logistic analy- sis showed that the history of blood transfusion/blood products （OR--13.97）, traumatic treatment for beauty （OR=4.03） and having face and beard shaved in barber shop （OR=4.72） were risk factors of HCV infection. HCV RNA was detected in 63.83% （60/94） of all HCV cases with predominant subtypes of lb （51.67%） and 2a （15.00%）, meanwhile subtypes of la, 3a, 3b, 6a, 6n were also identified. Patients with lb and 2a in- fection were usually older and retired. There was significant difference of distribution among patients with dif- ferent subtypes having history of traumatic treatment for beauty. Conclusions Blood transfusion/blood prod- ucts use, traumatic treatment for beauty and having face and beard shaved in barber shop are major risk factors of HCV infection in Pudong, and subtypes of lb and 2a are predominant locally, co-existing with other sub- types. The epidemic characteristics of various subtypes are different.

关 键 词：丙型肝炎病毒 病例对照研究 危险因素 基因分型 

分 类 号：R512.63[医药卫生—内科学]