Balasekaran R, Bulterys M, Jamal M M, Quinn P G, Johnston D E, Skipper B, Chaturvedi S, Arora S
Department of Medicine, University of New Mexico School of Medicine, Albuquerque 87131-5271, USA.
Am J Gastroenterol. 1999 May;94(5):1341-6. doi: 10.1111/j.1572-0241.1999.01084.x.
We performed a case-control study to evaluate risk factors and possible modes of transmission for hepatitis C virus (HCV) infection in patients with no history of blood transfusion or injection drug use.
Study subjects were selected from among patients seen in gastroenterology outpatient clinics at a university medical center in the southwestern United States. The study group consisted of 58 patients (12%) with chronic HCV infection who reported no history of transfusion or injection drug use, among a total of 477 patients evaluated for a positive HCV antibody test. These 58 patients were matched by age, ethnicity, and gender with 58 control patients diagnosed with gastroesophageal reflux attending the same clinics. Patients and controls were subjected to structured interviews and review of medical records.
A variety of variables were significantly associated with increased risk of sporadic HCV infection, including a history of tattoos, needlestick exposure, a history of sexually transmitted disease, intercourse with an injection drug user, five or more lifetime sexual partners, intercourse during menses (for women), lower income, and heavy alcohol intake (>60 g/day). Multivariate analysis identified a history of sexually transmitted disease, heavy alcohol intake, and the presence of a tattoo as independent risk factors for sporadic HCV. In addition, six cases and one control had a history of needlestick exposure. Of the cases, 88% had at least one of these four risk factors, as compared with 26% of controls (odds ratio = 16.5; 95% confidence interval = 4.0-68.8).
A history of sexually transmitted disease, heavy alcohol intake, the presence of tattoos, and a history of needlestick exposure were identified as risk factors for sporadic hepatitis C in this case-control study. If we include all patients with a history of blood transfusion or injection drug use, only 2% of the total 477 HCV patients had no identified risk factors.
我们开展了一项病例对照研究，以评估无输血或注射吸毒史的丙型肝炎病毒（HCV）感染患者的危险因素及可能的传播方式。
研究对象选自美国西南部一所大学医学中心胃肠病门诊所诊治的患者。在总共477例接受HCV抗体检测呈阳性的患者中，研究组由58例（12%）报告无输血或注射吸毒史的慢性HCV感染患者组成。这58例患者按年龄、种族和性别与在同一诊所被诊断为胃食管反流的58例对照患者进行匹配。对患者和对照进行结构化访谈并查阅病历。
多种变量与散发性HCV感染风险增加显著相关，包括纹身史、针刺暴露史、性传播疾病史、与注射吸毒者性交、一生中有五个或更多性伴侣、经期性交（女性）、低收入和大量饮酒（>60克/天）。多变量分析确定性传播疾病史、大量饮酒和纹身是散发性HCV的独立危险因素。此外，6例病例和1例对照有针刺暴露史。在病例中，88%至少有这四个危险因素中的一个，而对照中这一比例为26%（优势比=16.5；95%置信区间=4.0 - 68.8）。
在这项病例对照研究中，性传播疾病史、大量饮酒、纹身和针刺暴露史被确定为散发性丙型肝炎的危险因素。如果将所有有输血或注射吸毒史的患者包括在内，在总共477例HCV患者中，只有2%没有确定的危险因素。
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