Thaikruea Lakkana, Thongsawat Satawat, Maneekarn Niwat, Netski Dale, Thomas David L, Nelson Kenrad E
Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Transfusion. 2004 Oct;44(10):1433-40. doi: 10.1111/j.1537-2995.2004.04073.x.
The epidemiology, virology, and risk factors for hepatitis C virus (HCV) infection among blood donors in northern Thailand have not been extensively evaluated.
We did a prospective matched case-control study of blood donors who tested positive for HCV and were confirmed by recombinant immunoblot assay or nucleic acid testing. Infected donors were matched with one to four HCV-uninfected donors for sex, age +/- 5 years, and donation at the same site within 15 days of the HCV-positive donor. Married donors were invited to bring their spouse for HCV testing.
Among 166 matched sets, a history of intravenous drug use (IDU), reported by 58 HCV infected donors (35.5%) and 2 HCV-negative donors, was strongly associated with HCV infection (odds ratio [OR], 107.6; 95% confidence interval, 14.8-780.7). In multivariate analysis among donors without a history of IDU, significant risk factors included a history of a blood transfusion (OR, 28.8), immediate family with a history of hepatitis/jaundice (OR, 4.4), six or more lifetime sexual partners (OR, 2.7), and increased frequency of blood donation (OR, 0.9). Six of 45 spouses of HCV-infected donors, and none of 44 spouses of uninfected donors, were HCV positive (p = 0.005).
Our data indicate that illicit IDU and a history of transfusion are important risk factors for HCV infection in Thailand. Also, our data suggest there may be some risk of transmission by sex or other close contact between spouses.
泰国北部献血者中丙型肝炎病毒(HCV)感染的流行病学、病毒学及危险因素尚未得到广泛评估。
我们对HCV检测呈阳性且经重组免疫印迹试验或核酸检测确诊的献血者进行了一项前瞻性配对病例对照研究。将感染的献血者与一至四名未感染HCV的献血者按性别、年龄(±5岁)以及在HCV阳性献血者15天内于同一地点献血进行配对。已婚献血者被邀请带其配偶进行HCV检测。
在166对配对组中,58名HCV感染献血者(35.5%)和2名HCV阴性献血者报告有静脉注射毒品史(IDU),这与HCV感染密切相关(比值比[OR],107.6;95%置信区间,14.8 - 780.7)。在无IDU史的献血者的多因素分析中,显著的危险因素包括输血史(OR,28.8)、有肝炎/黄疸病史的直系亲属(OR,4.4)、终生有六个或更多性伴侣(OR,2.7)以及献血频率增加(OR,0.9)。45名HCV感染献血者的配偶中有6名HCV呈阳性,而44名未感染献血者的配偶均未感染(p = 0.005)。
我们的数据表明,非法IDU和输血史是泰国HCV感染的重要危险因素。此外,我们的数据表明配偶之间通过性行为或其他密切接触可能存在一定的传播风险。