Cadranel Jean-François, Di Martino Vincent, Lambrey Guy, Mourlhon Catherine, Nalet Bernard, Anciaux Marie-Laure, Richard Christian, Bigué Jean-Paul, Barjon Jean-Noël, Bories Christian, Barbare Jean-Claude, Halimi Chantal, Ribière Olivier, Eugène Claude, Pauwels Arnaud, Jeanne Sandrine, Donato Laurence, Dumouchel Patrice, Pariente Alexandre, Duverlie Gilles, Devergie Bruno, Arlot Sylvie, Capron Dominique
Picardie Hepatitis C network, Creil, France.
Eur J Gastroenterol Hepatol. 2008 Sep;20(9):829-36. doi: 10.1097/MEG.0b013e3282fc73a1.
Although there may exist a nosocomial risk of hepatitis C virus (HCV) infection in patients with type 1 or type 2 diabetes, this risk has not been fully investigated thus far and its magnitude is unknown. The aim of this multicenter cross-sectional study was to evaluate the prevalence of, and risk factors for, hepatitis C infection in consecutive hospitalized patients with diabetes and to assess the nosocomial risk and magnitude of HCV infection in these patients.
Consecutive hospitalized patients with diabetes seen in 11 French hepatogastroenterology and diabetology departments were studied. The prevalence of anti-HCV antibodies was compared with that observed in healthy blood donors and individuals seen during routine medical checkup. Diabetic patients with anti-HCV antibodies were compared with patients without anti-HCV antibodies for assessment of risk factors.
In total 1561 patients were studied. Independent risk factors for HCV infection were assessed through multivariate analysis. Thirty-three patients (2.11%) had anti-HCV antibodies and 21 (63.70%) had HCV identified risk factors. The prevalence of HCV infection was higher in patients with diabetes than in blood donors (0.08%) or healthy controls (0.20%) (P<0.001). Multivariate analysis identified four independent risk factors for HCV infection: blood transfusion before 1991 [odds ratio (OR)=2.88, P=0.033], intravenous drug use (OR=21.37, P=0.012), treatment in a hepatogastroenterology center (OR=4.17, P=0.002) and a high number (>2) of previous admissions since the onset of diabetes (OR=2.52, P=0.039).
A nosocomial source of HCV infection in hospitalized diabetic patients is suggested by the increased risk of HCV infection associated with the number of hospitalizations. This may account for at least 36% of cases of HCV infection.
虽然1型或2型糖尿病患者可能存在医院获得性丙型肝炎病毒（HCV）感染风险，但迄今为止该风险尚未得到充分研究，其程度也未知。这项多中心横断面研究的目的是评估连续性住院糖尿病患者中丙型肝炎感染的患病率和危险因素，并评估这些患者中HCV感染的医院获得性风险及程度。
对法国11个肝脏胃肠病学和糖尿病学科室收治的连续性住院糖尿病患者进行研究。将抗-HCV抗体的患病率与健康献血者及常规体检者中的患病率进行比较。对有抗-HCV抗体的糖尿病患者与无抗-HCV抗体的患者进行比较，以评估危险因素。
共研究了1561例患者。通过多变量分析评估HCV感染的独立危险因素。33例患者（2.11%）有抗-HCV抗体，21例（63.70%）有HCV确定的危险因素。糖尿病患者中HCV感染的患病率高于献血者（0.08%）或健康对照者（0.20%）（P<0.001）。多变量分析确定了HCV感染的四个独立危险因素：1991年前输血[比值比（OR）=2.88，P=0.033]、静脉吸毒（OR=21.37，P=0.012）、在肝脏胃肠病学中心接受治疗（OR=4.17，P=0.002）以及自糖尿病发病以来既往住院次数较多（>2次）（OR=2.52，P=0.039）。
与住院次数相关的HCV感染风险增加提示住院糖尿病患者存在医院获得性HCV感染源。这可能至少占HCV感染病例的36%。
