Garriga César, Manzanares-Laya Sandra, García de Olalla Patricia, Gorrindo Pilar, Lens Sabela, Solà Ricard, Martínez-Rebollar María, Laguno Montserrat, Navarro Jordi, Torras Xavier, Gurguí Mercè, Barberá María-Jesús, Quer Josep, Masdeu Eva, Simón Pere, Ros Miriam, de Andrés Anna, Caylà Joan A
Epidemiology Service, Public Health Agency of Barcelona, Barcelona, Spain.
Spanish Field Epidemiology Training Programme (FETP/PEAC), National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain.
PLoS One. 2017 Nov 14;12(11):e0187893. doi: 10.1371/journal.pone.0187893. eCollection 2017.
The aims of this study were to describe the evolution of acute hepatitis C virus (HCV) infections since 2004 and to determine its associated factors. Acute HCV infections diagnosed in Barcelona from 2004 to 2015 were included. Incidence ratios (IR) were then estimated for sex and age groups. Cases were grouped between 2004-2005, 2006-2011 and 2012-2015, and their incidence rate ratios (IRR) were calculated. In addition, risk factors for acute HCV infection were identified using multinomial logistic regression for complete, available and multiple imputed data. 204 new HCV cases were identified. Two peaks of higher IR of acute HCV infection in 2005 and 2013 were observed. Men and those aged 35-54 had higher IR. IRR for men was 2.9 times greater than in women (95% confidence intervals (CI): 1.8 ‒ 4.7). Factors related to the period 2012-2015 (versus 2006-2011) were: a) sexual risk factor for transmission versus nosocomial (relative-risk ratio (RRR): 13.0; 95% CI: 2.3 ‒ 72.1), b) higher educated versus lower (RRR: 5.4; 95% CI: 1.6 ‒ 18.7), and c) HIV co-infected versus not HIV-infected (RRR: 53.1; 95% CI: 5.7 ‒ 492.6). This is one of the few studies showing IR and RRRs of acute HCV infections and the first focused on a large city in Spain. Sexual risk for transmission between men, higher educational level and HIV co-infection are important factors for understanding current HCV epidemic. There has been a partial shift in the pattern of the risk factor for transmission from nosocomial to sexual.
本研究的目的是描述2004年以来急性丙型肝炎病毒（HCV）感染的演变情况，并确定其相关因素。纳入了2004年至2015年在巴塞罗那诊断出的急性HCV感染病例。然后估算了不同性别和年龄组的发病率比（IR）。病例被分为2004 - 2005年、2006 - 2011年和2012 - 2015年三组，并计算了它们的发病率比（IRR）。此外，使用多项逻辑回归分析完整、可用和多次插补数据，以确定急性HCV感染的危险因素。共识别出204例新的HCV病例。观察到2005年和2013年急性HCV感染的IR出现两个高峰。男性和35 - 54岁人群的IR较高。男性的IRR比女性高2.9倍（95%置信区间（CI）：1.8 - 4.7）。与2012 - 2015年期间（相对于2006 - 2011年）相关的因素有：a）性传播危险因素与医院感染（相对危险比（RRR）：13.0；95% CI：2.3 - 72.1），b）高学历与低学历（RRR：5.4；95% CI：1.6 - 18.7），以及c）合并感染HIV与未感染HIV（RRR：53.1；95% CI：5.7 - 492.6）。这是少数展示急性HCV感染的IR和RRR的研究之一，也是首个聚焦于西班牙大城市的研究。男性之间的性传播风险、高学历水平和HIV合并感染是理解当前HCV流行情况的重要因素。传播危险因素模式已从医院感染部分转向性传播。
