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慢性丙型肝炎感染的重大流行病学变化:全国性HEPNET - 希腊队列研究结果

Significant epidemiological changes in chronic hepatitis C infection: results of the nationwide HEPNET-GREECE cohort study.

作者信息

Raptopoulou M, Touloumi G, Tzourmakliotis D, Nikolopoulou G, Dimopoulou M, Giannoulis G, Vasiliadis T, Skoutelis A, Anagnostou O, Hatzis G, Manolakopoulos S

出版信息

Hippokratia. 2011 Jan;15(1):26-31.

Abstract

BACKGROUND AND AIMS

Hepatitis C virus (HCV) infection is an important health problem worldwide. The aim of the study is to describe the baseline characteristics and possible epidemiological changes of the patients with chronic HCV infection included in a nationwide Greek study.

PATIENTS AND METHODS

two thousand eight hundred seventeen (2817) patients, followed-up at 20 hepatology centres throughout Greece between the years 1997 and 2006 were enrolled in the study.

RESULTS

Intravenous drug use (IDU) and history of blood transfusion prior to 1992 was reported in 30.7% and 22.6% of our patients, respectively. In 1865 (66.2%) patients with known genotypes, the distribution for genotype 1, 2, 3 and 4 was 45.1%, 7%, 34% and 13.9% respectively. Genotype 1 was more common in older people, in women (55.9% p<0.001) and patients with transfusion-related hepatitis (61.6% p<0.001). Genotype 3 was more common in younger patients, in men (43% p<0.001) and in IDUs (63.3% p<0.001). A significant reduction of transfusion-related hepatitis C incidence (p<0.001) in conjunction with the proportion of genotype 1 (p<0.001) was observed during the last three decades while an increase in IDU infected patients and genotype 3 was detected.

CONCLUSIONS

Our study showed a significant change in HCV genotype distribution and source of HCV infection during the last three decades and under that scope, urgent actions are needed in order to control the spread of HCV infection.

摘要

背景与目的

丙型肝炎病毒(HCV)感染是全球重要的健康问题。本研究旨在描述纳入希腊全国性研究的慢性HCV感染患者的基线特征及可能的流行病学变化。

患者与方法

本研究纳入了1997年至2006年间在希腊20个肝病中心接受随访的2817例患者。

结果

分别有30.7%和22.6%的患者报告有静脉注射毒品史(IDU)和1992年前输血史。在1865例(66.2%)已知基因型的患者中,基因型1、2、3和4的分布分别为45.1%、7%、34%和13.9%。基因型1在老年人、女性(55.9%,p<0.001)和输血相关性肝炎患者中更常见(61.6%,p<0.001)。基因型3在年轻患者、男性(43%,p<0.001)和IDU患者中更常见(63.3%,p<0.001)。在过去三十年中,观察到输血相关性丙型肝炎发病率显著降低(p<0.001),同时基因型1的比例也显著降低(p<0.001),而IDU感染患者和基因型3有所增加。

结论

我们的研究表明,在过去三十年中HCV基因型分布和HCV感染源发生了显著变化,在此范围内,需要采取紧急行动以控制HCV感染的传播。

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