社区美沙酮维持治疗新入组者HCV感染率变化趋势及危险因素  

Changing trend of the prevalence of HCV infection and risk factors among new entrants in community-based methadone maintenance treatment

作　　者：刘茵[1,2] 邹霞[1,2] 徐勇[1,2] 邓立伟[1,2] 凌莉[1,2] 

机构地区：[1]中山大学公共卫生学院医学统计与流行病学系,广东广州510080 [2]中山大学流动人口卫生政策研究中心,广东广州510080

出　　处：《中华疾病控制杂志》2017年第1期35-39,共5页Chinese Journal of Disease Control & Prevention

基　　金：国家自然科学基金(81473065;71173245)

摘　　要：目的探讨社区美沙酮维持治疗(methadone maintenance treatment,MMT)新入组者丙型肝炎病毒(hepatitis C virus,HCV)感染率的变化趋势及相关危险因素。方法以2006-2014年广东省8 830名MMT新入组者为研究对象,计算不同年份HCV感染率,采用Logistic回归分析相关危险因素。结果 2006-2008年、2009-2011年、2012-2014年分别新入组4 485人、3 028人、1 317人,HCV感染率分别为77.1%、80.7%、77.0%,趋势性x^2检验差异无统计学意义(X_(趋势)~2=1.72,P=0.189)。多因素分析结果显示:2006-2008年较高的文化程度、已婚有配偶是HCV感染的保护因素(均有P<0.05);吸毒年限长、过去半年与毒友交往次数多、有注射吸毒史是HCV感染的危险因素(均有P<0.05)。2009-2011年较高的文化程度、已婚有配偶是HCV感染的保护因素(均有P<0.05);吸毒年限长、过去半年与毒友交往次数多、有注射吸毒史是HCV感染的危险因素(均有P<0.05)。2012-2014年女性、吸毒年限长、有注射吸毒史是HCV感染的危险因素(均有P<0.05)。结论 MMT新入组者HCV感染率较高且无下降趋势;危险因素有所变化,但吸毒年限长和注射吸毒是HCV感染的持续性高危因素。应进一步加强MMT门诊宣传及HCV防控工作。Objective To explore the changing trend of hepatitis C virus（ HCV） prevalence and risk factors among new entrants in community-based methadone maintenance treatment（ MMT）. Methods Totally 8 830 new entrants in MMT of Guangdong province were included in this study. HCV infection rates were calculated and logistic regression model was conducted to analyse related risk factors in different years. Results 4 485 new entrants in MMT were recruited from 2006 to 2008 and the prevalence of HCV infection was 77. 1%; 3 028 new entrants in MMT were recruited from 2009 to 2011 and the prevalence of HCV infection was 80. 7%; 1 317 new entrants in MMT were recruited from 2012 to 2014 and the prevalence of HCV infection was 77. 0%; Trend 2test was not statistical significant（ 2trend= 1. 72,P = 0. 189）.Multivariate Logistic regression analysis showed that in 2006- 2008,higher education level and being married were protective for HCV infection（ all P〈0. 05）,whereas long history of drug use,closer ties with drug fellows in the past six months and injecting drug use were risk factors for HCV infection（ all P〈0. 05）. In 2009- 2011,higher education level and being married were protective for HCV infection（ all P〈0. 05）,however,long history of drug use,closer ties with drug fellows in the past six months and injecting drug use were risk factors for HCV infection（ all P〈0. 05）. In 2012- 2014,female,long history of drug use and injecting drug use were risk factors for HCV infection（ all P〈0. 05）. Conclusions The prevalence of HCV infection among MMT new entrants was high and had no downtrend. The risk factors were changing,however,long history of drug use and injecting drug use were continuous risk factors for HCV infection. More intervention should be given to publicity of MMT to strengthen prevention and treatment of HCV.

关 键 词：美沙酮 肝炎病毒属 感染 危险因素 

分 类 号：R512.63[医药卫生—内科学] R181[医药卫生—临床医学]