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波兰丙型肝炎病毒感染的流行情况和危险因素。

Prevalence and risk factors of HCV infection in Poland.

机构信息

Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, ul. Zurawia 14, Poland.

出版信息

Eur J Gastroenterol Hepatol. 2011 Nov;23(12):1213-7. doi: 10.1097/MEG.0b013e32834d173c.

Abstract

BACKGROUND

According to small studies carried out in preselected populations, the estimated prevalence of anti-hepatitis C virus (HCV) antibodies in Poland ranges from 0.6 to 2.1%.

AIMS

The aim of this study was to evaluate the prevalence of anti-HCV and HCV RNA among patients and healthcare workers.

METHODS

Anti-HCV antibodies were measured (Elecsys, Roche) in serum samples from 26,057 adults, consecutive patients or healthcare workers, from hospitals and out patient clinics not involved in the management of liver diseases. The majority of them (18,233) consented to fill out an anonymous questionnaire related to possible risk factors for HCV infection. Anti-HCV-positive samples were assessed for HCV RNA (Cobas Amplicor, Roche). A multivariate logistic regression model and the χ² test or the Fisher's exact test were applied.

RESULTS

Anti-HCV antibodies were detected in 1.9% of individuals, and 31% of them demonstrated HCV RNA, which varied from 26% in hospitals to 66% in specialistic out-patient clinics. Prevalence of anti-HCV was significantly lower in healthcare workers (1.42%) than in patients (1.92%). Significant independent risk factors for anti-HCV positivity were as follows: male sex, more than three hospitalizations in a lifetime, blood transfusions before 1992, and intravenous drug use. The only significant risk factor for HCV RNA was intravenous drug use. An analysis carried out for multispecialistic hospitals demonstrated significantly lower prevalence of HCV RNA positivity in healthcare workers.

CONCLUSION

Prevalence of anti-HCV in the Polish population studied was up to 1.9%, but active infection could be diagnosed in only 31% of them. Intravenous drug use, blood transfusions before 1992, multiple hospitalizations, and male sex increase the risk of HCV infection.

摘要

背景

根据在预选人群中进行的小型研究,波兰抗丙型肝炎病毒 (HCV) 抗体的估计患病率在 0.6%至 2.1%之间。

目的

本研究旨在评估患者和医护人员中抗 HCV 和 HCV RNA 的流行率。

方法

检测了来自 26057 名成年人的血清样本中的抗 HCV 抗体(罗氏 Elecsys),这些成年人是来自未参与肝病管理的医院和门诊诊所的连续患者或医护人员。其中大多数(18233 人)同意填写一份与 HCV 感染可能风险因素相关的匿名问卷。对抗 HCV 阳性样本进行 HCV RNA(罗氏 Cobas Amplicor)检测。应用多变量逻辑回归模型和 χ²检验或 Fisher 确切检验。

结果

在 1.9%的个体中检测到抗 HCV 抗体,其中 31%的个体检测到 HCV RNA,其范围从医院的 26%到专科门诊的 66%不等。医护人员抗 HCV 的患病率(1.42%)明显低于患者(1.92%)。抗 HCV 阳性的显著独立危险因素如下:男性、一生中多次住院、1992 年前输血和静脉内药物使用。HCV RNA 的唯一显著危险因素是静脉内药物使用。对多专科医院进行的分析表明,医护人员 HCV RNA 阳性率明显较低。

结论

在所研究的波兰人群中,抗 HCV 的流行率高达 1.9%,但仅能在其中 31%的个体中诊断出活动性感染。静脉内药物使用、1992 年前输血、多次住院和男性增加了 HCV 感染的风险。

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