在中国北方的一个共用针具人群中，乙型和丙型肝炎病毒感染的流行情况和特征。
Prevalence and characterization of hepatitis B and C virus infections in a needle-sharing population in Northern China.
机构信息
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.
出版信息
BMC Public Health. 2015 May 2;15:460. doi: 10.1186/s12889-015-1808-0.
BACKGROUND
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.
METHODS
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.
RESULTS
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).
CONCLUSIONS
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.
背景
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。
方法
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。
结果
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）。
结论
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。
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