一项基于人群的北美人群丙型肝炎流行病学研究。
A population-based study of the epidemiology of hepatitis C in a North American population.
机构信息
Section of Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
出版信息
J Hepatol. 2012 Oct;57(4):736-42. doi: 10.1016/j.jhep.2012.05.018. Epub 2012 Jun 2.
BACKGROUND & AIMS: Chronic hepatitis C virus (HCV) infection is a major public health problem with approximately 3% of the world's population thought to be chronically infected. However, population-based data regarding HCV incidence rates, prevalence, residence, age, and gender distributions within North America are limited. We aimed at providing a detailed descriptive epidemiology of HCV infection in a North American population with a focus on time trends in incidence rates and prevalence of newly diagnosed HCV infection since 1991, the time when laboratory testing for HCV infections became first available.
METHODS
A Research Database was developed linking records from multiple administrative sources. HCV positive residents of the Canadian province of Manitoba were identified during a twelve-year period (1991-2002). The cumulative and annual incidence rates and the prevalence of newly diagnosed HCV infection in Manitoba were examined and compared between different demographic groups and urban vs. rural residents.
RESULTS
A total of 5018 HCV positive cases were identified over a 12-year period. The annual number of newly diagnosed HCV infections peaked in 1998 (59.2/100,000). On the other hand, the known prevalence of HCV continued to increase (4.6-fold during the 12-year study period) among both men and women reflecting the chronic nature of the disease. Males were 1.7 times more often infected than females. HCV infections were more common in urban centers.
CONCLUSIONS
Between 1995 and 2002, there was a fairly constant trend for newly diagnosed HCV infection, ranging from approximately 500 to 600 new cases annually. Hence, with a stable population size, and a low case fatality rate, the prevalence of HCV infected persons in our population has been steadily rising. There is no evidence to suggest that the incidence of HCV infection will raise, however, the burden of chronic HCV infection will continue to increase, particularly amongst older males and those residing in urban centers.
背景与目的
慢性丙型肝炎病毒（HCV）感染是一个主要的公共卫生问题，据估计，全球约有 3%的人口患有慢性 HCV 感染。然而，北美的 HCV 发病率、患病率、居住地、年龄和性别分布的基于人群的数据有限。我们旨在提供一个北美人 HCV 感染的详细描述性流行病学，重点关注自 1991 年（实验室 HCV 检测首次可用）以来新诊断 HCV 感染的发病率和患病率的时间趋势。
方法
建立了一个研究数据库，该数据库将来自多个行政来源的记录链接起来。在 12 年期间（1991-2002 年），鉴定了加拿大马尼托巴省的 HCV 阳性居民。检查并比较了不同人群和城市与农村居民之间曼尼托巴省新诊断 HCV 感染的累积和年度发病率和患病率。
结果
在 12 年期间共发现了 5018 例 HCV 阳性病例。新诊断 HCV 感染的年发病人数在 1998 年达到高峰（59.2/100000）。另一方面，HCV 的已知患病率在男性和女性中都继续增加（在 12 年的研究期间增加了 4.6 倍），反映了该疾病的慢性性质。男性感染的可能性是女性的 1.7 倍。HCV 感染在城市中心更为常见。
结论
在 1995 年至 2002 年期间，新诊断 HCV 感染呈相当稳定的趋势，每年约有 500-600 例新病例。因此，在人口规模稳定且病死率低的情况下，我们人群中 HCV 感染人群的患病率一直在稳步上升。没有证据表明 HCV 感染的发病率会上升，然而，慢性 HCV 感染的负担将继续增加，特别是在老年男性和居住在城市中心的人群中。
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