玉溪市红塔区美沙酮维持治疗者HCV和HIV抗体阳转分析  

Analysis of hepatitis C virus and HIV seroconversion among patients with methadone maintenance treatment in Hongta district, Yuxi prefecture

作　　者：陈锁玉 李世福[2] 蒋丹兰 董文斌[2] 杨绍华 鲁建波[2] 李顺祥[2] CHEN Suoyu;LI Shifu;JIANG Danlan;DONG Wenbin;YANG Shaohua;LU Jianbo;LI Shunxiang(Hongta District Centre for Disease Control and Prevention,Yuxi 653100,China;Yuxi Municipal Centre for Disease Control and Prevention,Yuxi 653100)

机构地区：[1]云南省红塔区疾病预防控制中心,云南玉溪653100 [2]云南省玉溪市疾病预防控制中心,云南玉溪653100

出　　处：《中国艾滋病性病》2020年第4期407-410,共4页Chinese Journal of Aids & STD

基　　金：云南省中青年学术技术带头后备人才培养项目(2016HB052)。

摘　　要：目的了解玉溪市红塔区美沙酮维持治疗者艾滋病病毒(HIV)及丙型肝炎病毒(HCV)抗体阳转情况,探讨相关的影响因素。方法对2008-2016年间玉溪市红塔区美沙酮维持治疗者进行随访,入组时开展问卷调查,入组时及随后每年进行HIV和HCV抗体检测,计算HIV和HCV抗体阳转率并运用COX比例风险回归模型分析其影响因素。结果分别有1 256名基线HIV抗体阴性和343名基线HCV抗体阴性的研究对象纳入队列,抗体阳转率分别为0.07/100人年[95%可信区间(CI):0.06~0.08/100人年]和12.69/100人年(95%CI:8.78~16.60/100人年)。多因素模型控制潜在的混杂作用后结果显示,入组时正在注射吸毒者、入组时首次美沙酮剂量> 25 mL者HCV抗体阳转的风险高于入组时未注射毒品和入组时首次美沙酮剂量≤25 mL者[风险比(HR)=3.54, 95%CI:1.64~7.62,HR=2.94, 95%CI:1.71~6.01]。HCV抗体阳转率由基线至第1次随访期间的21.61/100人年下降至第6~7次随访期间0/100人年。结论玉溪市红塔区美沙酮维持治疗在减少HIV经吸毒途径传播中初显成效,但HCV抗体阳转率仍然较高,其中入组时正在注射吸毒者、首次美沙酮剂量较高者HCV阳转风险较高,坚持服用美沙酮者HCV阳转风险较低。Objective To explore influence factors of HIV and Hepatitis C virus(HCV) seroconversion among drug users during methadone maintenance treatment(MMT) in Hongta district, Yuxi prefecture. Methods Clients to MMT clinics were followed-up between 2008 and 2016. HIV and HCV were tested as the baseline, and sociodemographic and drug use related information were collected by using a questionnaire. HCV and HIV seroconversion incidence was analyzed and Cox proportional hazard regression model was used for the risk factors. Results Clients to MMT clinics with 1 256 HIV-and 343 HCV-were included in the cohort study, and the seroconversion rate of HIV and HCV were 0.07/100 person-years(95%CI: 0.06-0.08/100 person-years) and 12.69/100 person-years(95%CI: 8.78-16.60/100 person-years). Cox proportional hazard regression model analysis indicated that after controlling the confounding variables, those who were injecting drugs, and received the first methadone dose > 25 ml at the time of enrollment were more likely to be HCV seroconversion than those who were not IDUs, and their first methadone dose ≤ 25 ml at the time of enrollment(HR=3.54, 95%CI:1.64-7.62, HR=2.94, 95%CI :1.71-6.01). HCV seroconversion rate declined from 21.61/100 person-years at baseline to 0/100 person-years among those who remained in treatment after 7 times of follow-up. Conclusion MMT is fairly effective in reducing HIV transmission but not in HCV infection through drug use in Hongta district, Yuxi prefecture. Those with IDUs and methadone dose > 25 ml at the time of enrollment of MMT are at higher risks of HCV seroconversion.

关 键 词：美沙酮 艾滋病病毒 丙型肝炎病毒 抗体阳转 影响因素 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]