北京市不同类型吸毒者丙型病毒性肝炎流行趋势及其行为特征变化  

Epidemic trends and behavioral changes of hepatitis C among different types of drug users in Beijing from 2017 to 2021

作　　者：李桂英[1] 孙燕鸣[1] 卢红艳[1] LI Guiying;SUN Yanming;LU Hongyan(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,北京100013

出　　处：《中华疾病控制杂志》2025年第3期296-303,共8页Chinese Journal of Disease Control & Prevention

基　　金：北京市重点人群艾滋病、病毒性肝炎及梅毒多病同防同治工作模式研究(首发2024-1G-3013)。

摘　　要：目的了解北京市传统毒品与新型毒品吸毒者丙型病毒性肝炎(简称丙肝)流行趋势及其行为特征变化,为在吸毒人群中开展丙肝防治提供参考。方法2017—2021年采取重复横断面研究,对北京市东城区、朝阳区和大兴区拘留所新入所的,并且符合研究对象定义的吸毒者进行问卷调查,获得吸毒人群危险行为特征,并采集血样进行丙型肝炎病毒(hepatitis C virus,HCV)、梅毒和人类免疫缺陷病毒(human immunodeficiency virus,HIV)检测。采用χ^(2)检验分析不同类型吸毒者2017—2021年丙肝流行趋势及其行为特征变化,采用多因素logistic回归分析模型分析不同类型毒品吸毒者感染HCV的危险因素。结果2017—2021年北京市吸毒人群HCV总体阳性率为19.9%,其中传统毒品吸毒者HCV阳性率(49.4%)高于新型毒品吸毒者(7.4%)。2019—2021年不同类型吸毒者HCV阳性率均呈上升趋势。传统毒品吸毒者曾经注射过毒品的比例呈逐年增加趋势,从2017年的59.6%增加到2021年的70.3%(χ^(2)=19.215,P=0.001)。2019—2021年新型毒品吸毒者曾经共用注射器的比例呈逐年增加趋势,从2019年的9.5%增加到2021年的15.9%(χ^(2)=23.469,P<0.001);多因素分析结果显示,北京市传统毒品吸毒者感染HCV的危险因素包括户籍(OR=5.49,95%CI:1.41~21.41)、曾经注射过毒品(OR=9.41,95%CI:2.39~36.99)、最近1次吸毒后发生性行为(OR=4.61,95%CI:1.24~17.18),曾经注射过毒品是新型毒品吸毒者感染HCV的特有危险因素(OR=12.04,95%CI:5.60~25.88,P<0.001)。结论2017—2021年北京市不同类型吸毒者HCV阳性率逐年上升,曾经注射过毒品和最近1次吸毒后发生性行为是吸毒人群HCV阳性率上升的主要原因,应加强对该人群高危行为干预、推广抗病毒治疗,从而降低吸毒人群丙肝的疾病负担。Objective To understand the epidemic trend of hepatitis C and changes of behavioral characteristics among different types of drug users in Beijing from 2017 to 2021,and to provide necessary information for developing targeted hepatitis C treatment and prevention strategy among drug users.Methods From 2017 to 2021,repeated cross-sectional surveys were conducted among drug users in Beijing,blood samples were collected for hepatitis C virus(HCV),syphilis,and HIV testing.Chi-square tests were used to analyze the trends in hepatitis C prevalence and changes in behavioral characteristics among different types of drug users.Multivariate logistic regression models were employed to identify risk factors for HCV infection among these populations.Results The overall prevalence of HCV positive among drug users in Beijing from 2017 to 2021 was 19.9%,The prevalence of HCV infection in different types of drug users had shown an upward trend from 2019 to 2021.Among the traditional drug users,the proportion of injecting drug use increased from 59.6%in 2017 to 70.3%in 2021(χ^(2)=19.215,P=0.001).Among the new-type drug users,the proportion of injecting drug use increased from 5.9%in 2017 to 10.8%in 2021(χ^(2)=23.469,P<0.001).Multivariate analysis showed that the risk factors of HCV infection in traditional drug users included household registration in Beijing(OR=5.49,95%CI:1.41-21.41),injecting drug use(OR=9.41,95%CI:2.39-36.99),and having sex after drug use(OR=4.61,95%CI:1.24-17.18),while the risk factors of HCV infection in new-type drug users was injecting drug use(OR=12.04,95%CI:5.60-25.88,P<0.001).Conclusions The prevalence of HCV infection among different types of drug users in Beijing had been increasing year by year from 2017 to 2021.The continuous existence of injecting drug use and unsafe sexual behavior was the main reason for the increase of hepatitis C among drug users.

关 键 词：丙型肝炎病毒 吸毒人群 人类免疫缺陷病毒 

分 类 号：R181[医药卫生—流行病学]