Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás (UFG), Goiânia, GO, Brasil.
Rev Saude Publica. 2009 Aug;43 Suppl 1:43-50. doi: 10.1590/s0034-89102009000800008.
To estimate prevalence of hepatitis C virus (HCV) infection and identify risk factors associated and circulating HCV genotypes and subtypes.
Study conducted including 691 drug users attending 26 charitable, private and public drug treatment centers in Goiânia and Campo Grande, central-western Brazil, between 2005 and 2006. Sociodemographic characteristics and risk factors for HCV infection were collected during interviews. Blood samples were tested for HCV antibodies (anti-HCV). Positive samples were submitted to HCV RNA detection by PCR with primers complementary to 5' NC and NS5B regions of viral genome and genotyped by line probe assay (LiPA) and direct nucleotide sequencing followed by phylogenetic analysis. The prevalence and odds ratio were calculated with 95% confidence intervals. Risk factors were first estimated in the univariate analysis (p<0.10) and then analyzed by hierarchical logistic regression. Statistical significance was assessed at a 5% significance level.
The prevalence of anti-HCV was 6.9% (95% CI: 5.2-9.2). The multivariate analysis of risk factors revealed that age over 30 years and injecting drug use were associated with HCV infection. HCV RNA was detected in 85.4% (41/48) of anti-HCV-positive samples. Thirty-three samples were genotyped as genotype 1 by LiPA, subtypes 1a (63.4%) and 1b (17.1%), and 8 samples (19.5%) were genotype 3, subtype 3a. The phylogenetic analysis of the NS5B region showed that 17 (68%), 5 (20%), and 3 (12%) samples were subtypes 1a, 3a, and 1b, respectively.
The results show a high prevalence of HCV infection and predominance of subtype 1a among drug users in Brazil. In addition, injecting drug use was a major risk factor associated with HCV infection.
估计丙型肝炎病毒（HCV）感染的流行率，并确定相关的危险因素以及循环 HCV 基因型和亚型。
本研究纳入了 2005 年至 2006 年间在巴西中西部戈亚尼亚和坎波格兰德的 26 家慈善、私人和公共药物治疗中心就诊的 691 名吸毒者。在访谈中收集了社会人口统计学特征和 HCV 感染的危险因素。采集血样检测 HCV 抗体（抗-HCV）。对阳性样本进行聚合酶链反应（PCR）检测 HCV RNA，引物互补于病毒基因组的 5' NC 和 NS5B 区，并通过线性探针分析（LiPA）和直接核苷酸测序进行基因分型，随后进行系统发育分析。使用 95%置信区间计算患病率和比值比。在单因素分析（p<0.10）中首先估计危险因素，然后通过分层逻辑回归进行分析。在 5%的显著性水平评估统计学意义。
抗-HCV 的流行率为 6.9%（95%CI：5.2-9.2）。多因素危险因素分析显示，年龄超过 30 岁和注射吸毒与 HCV 感染相关。在 48 份抗-HCV 阳性样本中，有 85.4%（41/48）检测到 HCV RNA。33 份样本通过 LiPA 鉴定为基因型 1，亚型 1a（63.4%）和 1b（17.1%），8 份样本（19.5%）为基因型 3，亚型 3a。NS5B 区的系统发育分析显示，17 份（68%）、5 份（20%）和 3 份（12%）样本分别为亚型 1a、3a 和 1b。
结果表明，巴西吸毒者 HCV 感染的流行率较高，且以 1a 亚型为主。此外，注射吸毒是与 HCV 感染相关的主要危险因素。
