北京市丙型肝炎病毒感染危险因素的病例对照研究  

A case-control study of risk factors for hepatitis C infection in Beijing

作　　者：邱倩[1] 王怀[2] 刘秀颖[1] 张卫[2] 庞星火[3] Qiu Qian;Wang Huai;Liu Xiuying;Zhang Wei;Pang Xinghuo(Research and Education Management Office,Beijing Center for Disease Prevention and Control,Beijing 100013,China;Institute for Immunization and Prevention,Beijing Center for Disease Prevention and Control,Beijing 100013,China;Administration Office,Beijing Center for Disease Prevention and Control,Beijing 100013,China)

机构地区：[1]北京市疾病预防控制中心科研与教学管理办公室,100013 [2]北京市疾病预防控制中心免疫预防所,100013 [3]北京市疾病预防控制中心中心办公室,100013

出　　处：《国际病毒学杂志》2024年第1期37-41,共5页International Journal of Virology

基　　金：首都卫生发展科研专项(2020-1-3011)。

摘　　要：目的分析北京地区既往丙型肝炎(丙肝)病毒(hepatitis C virus,HCV)感染者的危险因素,为明确北京市丙肝筛查重点人群提供依据.方法于2021年7月1日至2022年6月30日以北京市7家医院为研究场所,开展1:1配对的病例-对照研究.病例组为调查点在研究期间新报告的HCV抗体阳性者,对照组为与病例居住相同街(乡)、性别相同和年龄相差5岁以内的健康者.采用logistic回归模型进行危险因素的单因素分析,采用条件logistic回归模型分析HCV感染的危险因素结果研究共纳入感染者、对照组各581人.多因素分析结果输血史(OR=14.59,95%CI:6.16~34.54)、共用注射器史(OR=8.55,95%CI:1.67~43.68)、日常密切接触者中有丙肝患者(OR=2.06,95%CI:1.14~3.74)和手术治疗史(OR=1.84,95%CI:1.24~2.74)与既往HCV感染有较强关联.不同年龄组多因素分析显示,输血史为≤40岁组仅有的独立危险因素,>40岁组中手术治疗史、输血史、日常密切接触者中有丙肝患者、和共用注射器史是独立危险因素.结论手术治疗、输血和共用注射器可能是北京市既往HCV感染的主要危险因素,应以上述人群为重点人群加强丙肝筛查力度,从而发现更多潜在的HCV感染者,同时应对静脉药瘾人群和中老年人群加强HCV健康宣贯,提高人群整体认知水平和自我防护能力,以进一步降低北京地区HCV的人群感染情况.Objective To investigate the main risk factors for previous infection by hepatitis C virus(HCV)in Beijing,so as to provide basis in identifying priority populations for hepatitis C screening.Methods From January 2020 to June 2022,1:1 matched case-control study was conducted in 7 hospitals in Beijing.The newly reported anti-HCV antibody positive patients during study period were enrolled in case group and the healthy individuals of the same community(township),gender and an age difference of 5 years or less comparing to the patients were in the control group.The logistic regression analysis was used for univariate analysis for risk factors.The conditional logistic regression analysis was used to analyze the risk factors of HCV infection.Results A total of 581 pairs of cases and control subjects were enrolled in the study.Multivariate analysis indicated that history of blood transfusion(OR=14.59,95%CI:6.16-34.54),history of sharing syringe(OR=8.55,95%CI:1.67-43.68),hepatitis C patients among daily close contacts(OR=2.06,95%CI:1.14-3.74)and history of surgical operation(OR=1.84,95%CI:1.24-2.74)had significant correlation to previous HCV infection.Multifactorial analysis of different age groups showed that history of blood transfusion was the only independent risk factor among≤40 years old group while history of blood transfusion and sharing syringe,hepatitis C patients among daily close contacts and history of surgical operation were independent risk factors for>40 years old group.Conclusions The history of blood transfusion,syringe sharing or surgical operation were the main risk factors for previous HCV infection in Beijing.Screening for HCV should be enhanced with focus on above key groups to detect more potential HCV infected patients.Meanwhile,HCV health promotion should be strengthened among intravenous drug abusers and middle-aged and elderly people to improve the overall awareness and self-protection ability,so as to further reduce HCV infection in Beijing.

关 键 词：丙型肝炎病毒 危险因素 病例对照研究 

分 类 号：R512.63[医药卫生—内科学]