上海市社区戒毒人群丙型肝炎流行特征分析  

Epidemiological characteristics of hepatitis C among community-based detoxification population in Shanghai

作　　者：梁鹏飞 沈晓沛[2] 王葳 程华[2] 屈凌霄 周鑫[2] 周磊明[2] 潘晓 任宏[1] 李健[5] LIANG Pengfei;SHEN Xiaopei;WANG Wei;CHENG Hua;QU Lingxiao;ZHOU Xin;ZHOU Leiming;PAN Xiao;REN Hong;LI Jian(Department of Hepatitis Control and Prevention,Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China;Department of AIDS/STD Control and Prevention,Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China;Virus Detection Laboratory,Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China;Shanghai Drug Rehabilitation Administration,Shanghai 200080,China;National Center for AIDS/STD Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China)

机构地区：[1]上海市疾病预防控制中心肝炎防治科,上海200336 [2]上海市疾病预防控制中心艾滋病性病麻风病防治科,上海200336 [3]上海市疾病预防控制中心病毒检测实验室,上海200336 [4]上海市戒毒管理局,上海200080 [5]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206

出　　处：《中国艾滋病性病》2024年第7期688-692,共5页Chinese Journal of Aids & STD

基　　金：上海市加强公共卫生体系建设三年行动计划(GWVI-9);上海市卫生健康委青年课题(20224Y0333)。

摘　　要：目的 掌握上海市社区戒毒人群丙型肝炎(简称丙肝)流行特征,为优化戒毒人群丙肝防控策略提供科学依据。方法 多阶段分层整群抽取2022年上海市徐汇区、静安区和宝山区在管社区戒毒人员开展问卷调查,收集其一般人口社会学信息、既往吸食毒品情况、家庭收入、医疗保险和丙肝治疗意愿等信息,采血开展丙肝抗体检测、核酸检测以及和基因分型检测。结果 本次参加调查的社区戒毒人员1 590人,抗体阳性率为30.9%(492人),核酸阳性率为19.4%(308人),基因分型以6n(25.7%)、6a(18.0%)和3a(16.9%)为主,丙肝治疗意愿可达70.7%(1 124人)。调查显示:女性、45~59岁年龄组、初中及以下学历、吸食阿片类毒品、有注射吸毒史是社区戒毒人员感染丙肝的危险因素。44岁及以下年龄组、已婚或同居、吸食苯丙胺类毒品、家庭人均月收入高、个人缴纳医疗保险是治疗意愿的促进因素。结论 上海市社区戒毒人群丙肝感染率和治疗意愿均较高,但囿于收入水平和医疗保险缴纳不足,可能会影响实际治疗开展。建议重点针对女性、中老年、低学历、吸食阿片类毒品者和有注射吸毒史者等高风险人群开展丙肝防控,积极探索社区诊疗和家庭共济等支付模式,助力丙肝消除。Objective To understand the epidemiological characteristics of hepatitis C virus(HCV)among community-based detoxification populations in Shanghai,and to provide scientific evidence for optimizing prevention and control strategies for HCV in this population.Methods A multi-stage stratified cluster sampling method was used to conduct a questionnaire survey among community-based detoxification individuals in Xuhui District,Jing'an District,and Baoshan District of Shanghai in 2022.Data on general demographic information,history of drug use,family income,medical insurance,and willingness for HCV treatment were collected.Blood samples were collected for HCV antibody testing,nucleic acid testing,and genotyping.Results A total of 1590 community-based detoxification individuals were included in the survey.The HCV antibody positive rate was 30.9%(492 individuals),and the nucleic acid positive rate was 19.4%(308 individuals).The dominant genotypes were 6n(25.7%),6a(18.0%),and 3a(16.9%).Willingness for HCV treatment was 70.7%(1124 individuals).The survey indicated that female,age group of 45-59 years,education level of junior high school or below,a history of opiate drug use,and a history of injecting drug use were risk factors for HCV infection among community-based detoxification individuals.Factors promoting treatment willingness included age group of 44 years or below,being married or cohabiting,a history of amphetamine-type stimulant drug use,higher monthly family income per capita,and having personal health insurance.Conclusions The prevalence of HCV infection and treatment willingness among the community-based detoxification population in Shanghai is relatively high.However,limited income levels and inadequate medical insurance coverage may affect the actual implementation of treatment.It is recommended that targeted prevention and control measures for HCV should be implemented in high-risk populations,such as women,middle-aged and elderly individuals,those with low education levels,a history of opiate drug use,and a

关 键 词：丙型肝炎 社区戒毒 流行特征 

分 类 号：R512.6[医药卫生—内科学]