美国和中国北方丙型肝炎病毒传播模式的时间变化

Temporal Changes in the Modes of Hepatitis C Virus Transmission in the USA and Northern China.

作者信息

Wu Elizabeth, Yang Ming, Rao Huiying, Fu Sherry, Feng Bo, Fei Ran, Lin Andy, Fontana Robert J, Wei Lai, Lok Anna S

机构信息

Division of Gastroenterology and Hepatology, University of Michigan Health System, 1500 E Medical Center Drive, 3912 Taubman Center, SPC 5362, Ann Arbor, MI, 48109, USA.

Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, 11 South Xizhimen St, Beijing, 100044, China.

出版信息

Dig Dis Sci. 2017 Aug;62(8):2141-2149. doi: 10.1007/s10620-017-4619-6. Epub 2017 Jun 1.

DOI:10.1007/s10620-017-4619-6

PMID:28573509

Abstract

BACKGROUND

Predominant modes of hepatitis C virus (HCV) transmission vary between countries and over time.

AIMS

To compare HCV transmission modes in the USA and northern China.

METHODS

We conducted a prospective study enrolling two cohorts of chronic HCV patients in the USA, and in China at Beijing, and at Gu'an and Kuancheng counties in Hebei. Patients self-reported the most likely source and year of infection.

RESULTS

A total of 1957 patients were studied (1000 USA; 957 China-428 Beijing, 387 Gu'an, 142 Kuancheng). The predominant infection sources were transfusion (23.0%) and injection drug use (IDU) (32.1%) in the USA and transfusion (64.5%) in northern China. Within China, transfusion was the most common source in Beijing (62.1%) and Gu'an (88.1%), and medical procedures (35.9%) and IDU (12.0%) in Kuancheng. Infection via transfusion decreased significantly in the USA (35.1-4.6%) and Beijing (84.2-14.3%) but remained frequent in Gu'an (90.5-72.5%) over time. Infection via IDU decreased from 32.4% in those ≥61 years to 25.0% in those 41-50 years but increased to 46.5% in those ≤40 years in US patients and decreased over time from 38.7 to 1.9% in Kuancheng. Infection via medical procedures increased over time in Beijing (7.0-33.3%) and remained frequent in Kuancheng (45.2-31.1%).

CONCLUSIONS

There are major differences in presumed HCV infection source between the USA and northern China. Favorable as well as worrisome changes in the modes of HCV transmission in both countries were observed.

摘要

背景

丙型肝炎病毒（HCV）的主要传播方式因国家和时间而异。

目的

比较美国和中国北方的HCV传播方式。

方法

我们进行了一项前瞻性研究，纳入了美国以及中国北京、河北固安和宽城县的两组慢性HCV患者队列。患者自行报告最可能的感染源和感染年份。

结果

共研究了1957例患者（美国1000例；中国957例，其中北京428例、固安387例、宽城142例）。在美国，主要感染源是输血（23.0%）和注射吸毒（IDU）（32.1%），而在中国北方是输血（64.5%）。在中国境内，输血是北京（62.1%）和固安（88.1%）最常见的感染源，而在宽城，医疗操作（35.9%）和IDU（12.0%）是主要感染源。随着时间推移，美国（35.1% - 4.6%）和北京（84.2% - ...... 14.3%）经输血感染显著减少，但固安（90.5% - 72.5%）仍很常见。美国患者中，≥61岁人群经IDU感染率从32.4%降至41 - 50岁人群的25.0%，但≤40岁人群中升至46.5%，宽城经IDU感染率随时间从38.7%降至1.9%。北京经医疗操作感染率随时间上升（7.0% - 33.3%），宽城仍很常见（45.2% - 31.1%）。