加拿大创伤人群中人类免疫缺陷病毒、乙型肝炎和丙型肝炎的血清流行率。

Human immunodeficiency virus, hepatitis B, and hepatitis C seroprevalence in a Canadian trauma population.

作者信息

Xeroulis George, Inaba Kenji, Stewart Tanya Charyk, Lannigan Rob, Gray Daryl, Malthaner Richard, Parry N Gil, Girotti Murray

机构信息

Trauma Program, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada.

出版信息

J Trauma. 2005 Jul;59(1):105-8. doi: 10.1097/01.ta.0000171464.51584.f5.

DOI:10.1097/01.ta.0000171464.51584.f5

PMID:16096548

Abstract

BACKGROUND

The current seroprevalence of human immunodeficiency virus (HIV), hepatitis B, and hepatitis C in the Canadian trauma population is unknown. Establishing the seroprevalence of these diseases is vital for education, postexposure prophylaxis, and counseling, and to establish potential screening guidelines. The purpose of this study was to determine the seroprevalence of HIV, hepatitis B, and hepatitis C in the trauma population of London, Ontario, Canada.

METHODS

All adult (aged > or = 18 years) trauma patients treated by the trauma team at London Health Sciences Centre were prospectively studied from January to December 2003. The study was conducted as a linked, confidential serosurvey with delayed full disclosure. Serum was analyzed for HIV, hepatitis C antibody, and Hepatitis B surface antigen.

RESULTS

A total of 287 (76%) of 377 consecutive trauma patients had blood testing completed. Of the 287 patients tested, 1 (0.3%) was positive for hepatitis B, 8 (2.8%) were positive for hepatitis C, and no patients tested positive for HIV. Hepatitis C-positive patients were predominantly men (63%) with a mean age of 46 years and a mean Injury Severity Score of 19; 63% were injured in a motor vehicle crash, and 88% were discharged alive. There were no statistically significant differences in the demographic and injury profiles from the hepatitis C-negative patients (p > 0.2 for all).

CONCLUSION

This is the first study to determine the rates of HIV, hepatitis B, and hepatitis C in the Canadian trauma population. Our trauma population demonstrated a threefold higher hepatitis C seroprevalence rate compared with the general population. Hepatitis C poses the highest risk to the trauma team of the three bloodborne diseases studied. With no vaccine or postexposure prophylaxis currently available for hepatitis C, this study highlights the importance of prevention and the strict use of universal precautions in the setting of trauma.

摘要

背景

加拿大创伤人群中人类免疫缺陷病毒（HIV）、乙型肝炎和丙型肝炎的当前血清流行率尚不清楚。确定这些疾病的血清流行率对于教育、暴露后预防和咨询以及制定潜在的筛查指南至关重要。本研究的目的是确定加拿大安大略省伦敦市创伤人群中HIV、乙型肝炎和丙型肝炎的血清流行率。

方法

对2003年1月至12月在伦敦卫生科学中心接受创伤团队治疗的所有成年（年龄≥18岁）创伤患者进行前瞻性研究。该研究作为一项关联的、保密的血清学调查进行，延迟全面披露。对血清进行HIV、丙型肝炎抗体和乙型肝炎表面抗原分析。

结果

377例连续创伤患者中共有287例（76%）完成了血液检测。在287例检测患者中，1例（0.3%）乙型肝炎呈阳性，8例（2.8%）丙型肝炎呈阳性，无患者HIV检测呈阳性。丙型肝炎阳性患者主要为男性（63%），平均年龄46岁，平均损伤严重程度评分为19分；63%在机动车碰撞中受伤，88%存活出院。丙型肝炎阴性患者的人口统计学和损伤特征无统计学显著差异（所有p>0.2）。