Department of Infectious Diseases, People's Hospital of Kuancheng Manchu Nationality Autonomous County, Hebei, 067600, China.
Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, No. 11 Xizhimen South Street, Beijing, 100044, China.
BMC Public Health. 2015 May 2;15:460. doi: 10.1186/s12889-015-1808-0.
The epidemiologies of hepatitis C virus (HCV) and hepatitis B virus (HBV) infections in specific populations in certain areas of China are poorly understood. A pilot survey of HCV/HBV infections was carried out in villages in Kuancheng County, Heben Province, where injection of sodium benzoate or amphetamines using shared needles has been a common practice. The aims of this study were to analyze the endemicity and characterize HCV/HBV infections in this population.
Data on demographic characteristics and drug abuse were collected from individuals who signed informed consent forms. Serum HCV antibody (anti-HCV), hepatitis B surface antigen (HBsAg), and hepatitis B core antibody (anti-HBc) were measured in all participants. HCV RNA was measured in samples positive for anti-HCV using real-time polymerase chain reaction.
Among 852 participants from 11 villages, 49.9% had used sodium benzoate or amphetamine at least once, by intravenous injection. The overall prevalence of anti-HCV, HCV RNA, anti-HBc, HBsAg, and HCV/HBV co-infection was 37.1%, 26.6%, 67.7%, 10.7%, and 30.0%, respectively. Two-hundred-twenty-three of 227 (98.2%) participants positive for HCV RNA were aged >40 years. Co-infection was related to sex, age, number of injections, and time from first injection. The rate of spontaneous HCV RNA clearance was 28.2% (89/316), and was related to the number of injections, time from first injection, and HBsAg positivity. However, HBsAg was related to the anti-HBc signal/cut-off ratio rather than to the above parameters. Trend tests demonstrated that the prevalence of anti-HCV, HCV RNA, and anti-HBc was related to the number of injections (P < 0.001), while HBsAg prevalence was not (P = 0.347).
The prevalence of HCV and HBV infection is likely to be high among individuals older than 40 years in areas of needle sharing, and one-time screening for HCV infection should be offered to these populations.
中国某些地区特定人群中丙型肝炎病毒（HCV）和乙型肝炎病毒（HBV）感染的流行病学情况了解甚少。本研究在河北省宽城县村庄开展了一项 HCV/HBV 感染的试点调查，该地区曾普遍存在共用针具注射苯甲酸钠或安非他命的情况。本研究旨在分析该人群中 HCV/HBV 感染的流行情况并对其特征进行描述。
从签署知情同意书的个体中收集人口统计学特征和药物滥用数据。对所有参与者检测血清丙型肝炎病毒抗体（抗-HCV）、乙型肝炎表面抗原（HBsAg）和乙型肝炎核心抗体（抗-HBc）。使用实时聚合酶链反应检测抗-HCV 阳性样本中的 HCV RNA。
在来自 11 个村庄的 852 名参与者中，49.9%至少曾有过一次通过静脉注射使用苯甲酸钠或安非他命的经历。抗-HCV、HCV RNA、抗-HBc、HBsAg 和 HCV/HBV 合并感染的总患病率分别为 37.1%、26.6%、67.7%、10.7%和 30.0%。在 227 名 HCV RNA 阳性的参与者中，有 223 名（98.2%）年龄大于 40 岁。合并感染与性别、年龄、注射次数和首次注射后时间有关。HCV RNA 自发清除率为 28.2%（89/316），与注射次数、首次注射后时间和 HBsAg 阳性有关。然而，HBsAg 与抗-HBc 信号/截断比值有关，而与上述参数无关。趋势检验表明，抗-HCV、HCV RNA 和抗-HBc 的流行与注射次数有关（P<0.001），而 HBsAg 流行与注射次数无关（P=0.347）。
在共用针具地区，年龄大于 40 岁的人群中 HCV 和 HBV 感染的流行率可能很高，应向这些人群提供 HCV 感染的一次性筛查。
