Butterfield Marian I, Bosworth Hayden B, Stechuchak Karen M, Frothingham Richard, Bastian Lori A, Meador Keith G, Swartz Marvin, Horner Ron D
Health Services Research and Development, Durham VAMC, NC 27705, USA.
J Natl Med Assoc. 2004 Jan;96(1):43-52.
Racial differences in the seroprevalence of and risks for hepatitis B (HBV) and hepatitis C (HCV) were examined in military veterans with severe mental illnesses (SMI). Participants (376; 155 Caucasian, 221 African American) were inpatients at a Veterans Affairs (VA) psychiatric unit in Durham, N.C., from 1998 to 2000. Prevalence rates of HBV and HCV were 21.3% and 18.9%, respectively. African Americans had a higher HBV seroprevalence than did Caucasians: 27.6% versus 12.3%; odds ratio (OR) 2.73; 95% confidence interval (CI)=1.55, 4.79. Although not statistically significant, HCV seroprevalence was also higher for African Americans than it was for Caucasians: 21.3% versus 15.5%; OR=1.47; 95% CI=0.86, 2.53. No racial difference was observed for injection drug use (IDU), the strongest risk indicator for both HBV and HCV. Multivariable analyses indicated that African-American race, IDU, and multiple sex partners in the past six months were related to an increased risk of HBV, whereas IDU and smoking crack cocaine were both independently related to an increased risk of HCV. Thus, veterans with SMI--particularly African-American veterans--have high rates of HBV and HCV infection. African-American veterans have significantly higher rates of HBV than do Caucasian veterans, which persist after controlling for prominent risk behaviors.
对患有严重精神疾病（SMI）的退伍军人中乙型肝炎（HBV）和丙型肝炎（HCV）的血清流行率及风险的种族差异进行了研究。参与者（共376人；155名白种人，221名非裔美国人）于1998年至2000年期间在北卡罗来纳州达勒姆市的一家退伍军人事务部（VA）精神病科住院。HBV和HCV的流行率分别为21.3%和18.9%。非裔美国人的HBV血清流行率高于白种人：分别为27.6%和12.3%；优势比（OR）为2.73；95%置信区间（CI）=1.55，4.79。虽然未达到统计学显著水平，但非裔美国人的HCV血清流行率也高于白种人：分别为21.3%和15.5%；OR = 1.47；95% CI = 0.86，2.53。在注射吸毒（IDU）方面未观察到种族差异，而注射吸毒是HBV和HCV最强的风险指标。多变量分析表明，非裔美国人种族、注射吸毒以及过去六个月内有多个性伴侣与HBV风险增加有关，而注射吸毒和吸食强效纯可卡因均独立与HCV风险增加有关。因此，患有严重精神疾病的退伍军人——尤其是非裔美国退伍军人——HBV和HCV感染率很高。非裔美国退伍军人的HBV感染率显著高于白种人退伍军人，在控制了主要风险行为后这一差异仍然存在。
