Cheng Wanting, Yang Ya, Zhou Yibiao, Xiao Penglei, Shi Yan, Gao Jianchuan, Chen Yue, Liang Song, Yihuo Wuli, Song Xiuxia, Jiang Qingwu
Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.
Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.
BMJ Open. 2017 Aug 11;7(8):e015717. doi: 10.1136/bmjopen-2016-015717.
Hepatitis C virus (HCV) infection is a major public health problem in southwestern China. Our aim of the study was to assess the prevalence of HCV infection and its correlates in the Yi population of this region.
A community-based survey was conducted to investigate sociodemographic characteristics and other associated factors for HCV infection in a rural area of southwestern China. Blood samples were collected and tested for antibodies to HCV. Anti-HCV positive samples were further assessed for HCV RNA.
A total of 2558 participants aged 14 years were included in our analysis. Of them, 2.8% (95% CI 2.2% to 3.5%) were positive for HCV antibody. Multiple logistic regression analysis revealed that sex (male vs female: adjusted OR (aOR)=3.30, 95% CI 1.80 to 6.07), marital status (unmarried vs married: aOR=0.27, 95% CI 0.09 to 0.80), ever using injection drug (aOR=28.65, 95% CI 15.9 to 51.64) and ever having blood transfusion (aOR=7.64, 95% CI 1.94 to 30.16) were significantly associated with HCV infection (indicated by positive HCV antibody). Stratified analysis by HIV infection found that in HIV-negative individuals, sex (male vs female: aOR=3.84, 95% CI 1.88 to 7.85), ever using injection drug (aOR=22.15, 95% CI 8.45 to 58.04), having multiple sexual partners (aOR=2.57, 95% CI 1.26 to 5.23), and ever having blood transfusion (aOR=16.54, 95% CI 4.44 to 61.58) were significantly associated with HCV infection and in HIV-positive individuals, ever using injection drug (aOR=8.96, 95% CI 3.16 to 25.38) was associated with HCV infection.
The data suggested a higher risk of HCV infection in this area when compared with the rest of China and some unique associated factors. Rapid scale-up of targeted interventions are needed to prevent further transmission and consequent morbidities.
丙型肝炎病毒（HCV）感染是中国西南部的一个主要公共卫生问题。本研究的目的是评估该地区彝族人群中HCV感染的患病率及其相关因素。
在中国西南部农村地区开展了一项基于社区的调查，以调查HCV感染的社会人口学特征和其他相关因素。采集血样并检测HCV抗体。抗-HCV阳性样本进一步检测HCV RNA。
共有2558名14岁及以上的参与者纳入我们的分析。其中，2.8%（95%CI 2.2%至3.5%）的HCV抗体呈阳性。多因素logistic回归分析显示，性别（男性与女性：调整后比值比（aOR）=3.30，95%CI 1.80至6.07）、婚姻状况（未婚与已婚：aOR=0.27，95%CI 0.09至0.80）、曾使用注射毒品（aOR=28.65，95%CI 15.9至5l.64）和曾接受输血（aOR=7.64，95%CI 1.94至30.16）与HCV感染（以HCV抗体阳性表示）显著相关。按HIV感染情况进行分层分析发现，在HIV阴性个体中，性别（男性与女性：aOR=3.84，95%CI 1.88至7.85）、曾使用注射毒品（aOR=22.15，95%CI 8.45至58.04）、有多个性伴侣（aOR=2.57，95%CI 1.26至5.23）和曾接受输血（aOR=16.54，95%CI 4.44至61.58）与HCV感染显著相关；在HIV阳性个体中，曾使用注射毒品（aOR=8.96，95%CI 3.16至25.38）与HCV感染相关。
数据表明，与中国其他地区相比，该地区HCV感染风险更高，且存在一些独特的相关因素。需要迅速扩大有针对性的干预措施，以防止进一步传播及由此导致的发病情况。
