长沙市部分抗-HCV阳性育龄妇女核酸检测状况及其影响因素的研究  

Nucleic acid testing status and influencing factors among anti-HCV positive women of reproductive age in Changsha

作　　者：蔡丽霞 陈嘉粤 王常合 姚均[1] 殷文渊[1] CAI Lixia;CHEN Jiayue;WANG Changhe;YAO Jun;YIN Wenyuan(National Center for AIDS/STD Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China;Changsha Hospital for Maternal&Child Health Care Afiliated to Hunan Normal University,Changsha 410007,Hunan,China;Maternal and Child Health Center,National Health Commission,Beijing 100191,China)

机构地区：[1]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206 [2]湖南师范大学附属长沙市妇幼保健院,长沙410007 [3]国家卫生健康委妇幼健康中心,北京100191

出　　处：《中国艾滋病性病》2025年第3期249-253,共5页Chinese Journal of Aids & STD

摘　　要：目的了解长沙市部分丙型肝炎抗体(抗-HCV)阳性育龄妇女HCV核酸(HCV RNA)检测状况,并分析影响核酸检测的相关因素,为育龄妇女的丙肝防治工作提供参考依据。方法从长沙市某三级甲等妇幼保健院的传染病信息系统中导出2019年6月至2023年12月在该院求诊的18~49岁育龄期且抗-HCV阳性者,进行全员问卷调查,收集其社会人口学特征、丙肝知识与相关风险行为、卫生服务以及社会支持等信息。采用χ^(2)检验对不同特征患者HCV RNA检测进行单因素分析,采用非条件二分类Logistic回归模型分析HCV RNA检测的相关影响因素。结果调查期间共有89073名18~49岁的育龄妇女接受过抗-HCV检测,其中150人抗-HCV阳性。对全部抗-HCV阳性者进行问卷调查,共143人完成,其中87人(60.8%)接受了HCV RNA检测;78人HCV RNA阳性,阳性比例89.7%(78/87)。72人接受过不同方案的丙肝抗病毒治疗,包括17人接受过直接抗病毒治疗(DAAs)。非条件二分类Logistic回归模型多因素分析显示,月收入≥5000元(OR=6.094,95%CI:1.462~25.402)、知晓丙肝具备有效药物治疗(OR=4.269,95%CI:1.532~11.891)、知晓丙肝可治愈(OR=8.713,95%CI:3.180~23.874)及首诊医院因无法进行HCV RNA检测而建议转诊去其他医院诊治者(OR=3.580,95%CI:1.195~10.726)更有可能接受HCV RNA检测。结论长沙市抗-HCV阳性育龄妇女HCV RNA检测率偏低,核酸检测工作存在较大差距。今后应进一步加强在育龄妇女中的丙肝防治知识宣传,特别是提供丙肝有可治愈性药物及预防母婴传播等关键信息,同时进一步规范和加强丙肝诊疗工作,包括完善转诊服务等,以促进更多育龄妇女接受HCV RNA检测和及时启动后续抗病毒治疗。Objective To investigate the status of hepatitis C virus(HCV)nucleic acid(RNA)testing among antiHCV positive childbearing-aged women in Changsha and analyze the factors influencing nucleic acid testing,providing a reference for hepatitis C prevention and treatment in this population.Methods Data were extracted from the infectious disease information system of a tertiary maternity and child health hospital in Changsha for women aged 18-49 years who tested positive for anti-HCV between June 2019 and December 2023.A questionnaire survey was conducted to collect information on sociodemographic characteristics,knowledge about hepatitis C,risk behaviors,health services,and social support.Chi-square tests were used for the univariate analysis of HCV RNA among different patient groups,and a nonconditional binary logistic regression model was used to identify the influencing factors.Results During the survey period,89073 women aged 18-49 years underwent anti-HCV testing,among whom 150 tested positive.Of 150 anti-HCVpositive individuals surveyed,143 completed the questionnaire.Among them,87(60.8%)underwent HCV RNA testing,and 78 tested positive for HCV RNA(positivity rate:89.7%(78/87)).A total of 72 individuals received hepatitis C antiviral therapy under various regimens,including 17 who received direct-acting antiviral agents(DAAs).Multivariate analysis using a non-conditional binary logistic regression model showed that individuals with a monthly income of≥5000 yuan(OR=6.094,95%CI:1.462-25.402),awareness of effective treatment for hepatitis C(OR=4.269,95%CI:1.532-11.891),awareness of the curability of hepatitis C(OR=8.713,95%CI:3.180-23.874),and those referred to other hospitals for HCV RNA testing due to the inability of the initial hospital to perform the test(OR=3.580,95%CI:1.195-10.726)were more likely to undergo HCV RNA testing.Conclusions The HCV RNA testing rate among anti-HCV-positive women of childbearing age in Changsha was relatively low,with significant gaps in nucleic acid testing.Future efforts should fo

关 键 词：丙型肝炎 育龄妇女 抗体阳性 核酸检测 影响因素 

分 类 号：R512.6[医药卫生—内科学]