加拿大中部原住民的丙型肝炎危险因素分布和 HCV 治疗结果。
Distribution of Hepatitis C Risk Factors and HCV Treatment Outcomes among Central Canadian Aboriginal.
机构信息
Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
出版信息
Can J Gastroenterol Hepatol. 2016;2016:8987976. doi: 10.1155/2016/8987976. Epub 2016 Apr 17.
Background. Aboriginal Canadians face many lifestyle risk factors for hepatitis C exposure. Methods. An analysis of Ottawa Hospital Viral Hepatitis Clinic (Ottawa, Canada) patients between January 2000 and August 2013 was performed. HCV infection risk factors and HCV treatment outcomes were assessed. Socioeconomic status markers were based on area-level indicators linked to postal codes using administrative databases. Results. 55 (2.8%) Aboriginal and 1923 (97.2%) non-Aboriginal patients were evaluated. Aboriginals were younger (45.6 versus 49.6 years, p < 0.01). The distribution of gender (63.6% versus 68.3% male), HIV coinfection (9.1% versus 8.1%), advanced fibrosis stage (29.2% versus 28.0%), and SVR (56.3% versus 58.9%) was similar between groups. Aboriginals had a higher number of HCV risk factors, (mean 4.2 versus 3.1, p < 0.001) with an odds ratio of 2.5 (95% confidence interval: 1.4-4.4) for having 4+ risk factors. This was not explained after adjustment for income, social deprivation, and poor housing. Aboriginal status was not related to SVR. Aboriginals interrupted therapy more often due to loss to follow-up, poor adherence, and substance abuse (25.0% versus 4.6%). Conclusion. Aboriginal Canadians have higher levels of HCV risk factors, even when adjusting for socioeconomic markers. Despite facing greater barriers to care, SVR rates were comparable with non-Aboriginals.
背景
加拿大原住民面临许多导致丙型肝炎病毒暴露的生活方式风险因素。方法：对 2000 年 1 月至 2013 年 8 月期间在渥太华医院病毒性肝炎诊所（加拿大渥太华）的患者进行了分析。评估了丙型肝炎病毒感染危险因素和丙型肝炎病毒治疗结果。社会经济地位指标基于与邮政编码相关的区域水平指标，使用行政数据库。结果：评估了 55 名原住民（2.8%）和 1923 名非原住民（97.2%）患者。原住民更年轻（45.6 岁比 49.6 岁，p < 0.01）。两组间的性别分布（63.6%比 68.3%男性）、HIV 合并感染（9.1%比 8.1%）、晚期纤维化阶段（29.2%比 28.0%）和 SVR（56.3%比 58.9%）相似。原住民有更多的丙型肝炎病毒危险因素（平均 4.2 比 3.1，p < 0.001），具有 4 个及以上危险因素的比值比为 2.5（95%置信区间：1.4-4.4）。调整收入、社会剥夺和住房条件差后，这种情况仍未得到解释。原住民的 SVR 率与社会经济地位无关。原住民因失访、治疗顺应性差和药物滥用中断治疗更为常见（25.0%比 4.6%）。结论：即使调整了社会经济指标，加拿大原住民仍有更高水平的丙型肝炎病毒危险因素。尽管面临更多的治疗障碍，但 SVR 率与非原住民相似。
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