Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
Clinical Research Centre, Ministry of Health Malaysia, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia.
PLoS One. 2019 Oct 29;14(10):e0224459. doi: 10.1371/journal.pone.0224459. eCollection 2019.
Hepatitis C infection is a global public health problem. This study was designed to identify the risk factors associated with hepatitis C infection among adult patients in Kedah state, Malaysia. A matched, hospital-based, case-control study was conducted at a tertiary hospital. Cases were adult (aged ≥ 18 years) patients with positive serology test results for hepatitis C virus antibody and detectable hepatitis C virus RNA from January 2015 to December 2018, and controls were age-, sex- and ethnicity-matched patients who were not infected with hepatitis C virus. Self-administered questionnaires were used to collect data on demographic characteristics and previous exposure to selected risk factors among the study participants. Associations between hepatitis C and demographic and risk factors were assessed using univariable and multivariable logistic regression analyses. A total of 255 case-control patient pairs were enrolled. The multivariable analysis indicated that having a history of blood or blood product transfusion before 1992 (adjusted odds ratio [AOR] = 6.99, 95% confidence interval [CI]: 3.73-13.81), injection drug use (AOR = 6.60, 95% CI: 3.66-12.43), imprisonment (AOR = 4.58, 95% CI: 1.62-16.40), tattooing (AOR = 3.73, 95% CI: 1.37-12.00), having more than one sexual partner (AOR = 2.06, 95% CI: 1.16-3.69), piercing (AOR = 1.71, 95% CI: 1.04-2.80), and having only secondary education (AOR = 1.92, 95% CI: 1.06-3.57) were independently associated with hepatitis C. No associations were found between health care occupation, needle-prick injury, surgical procedures, haemodialysis, acupuncture, cupping, or contact sports and hepatitis C infection. These findings demonstrate that hepatitis C risk is multifactorial. Having a history of blood or blood product transfusion before 1992, injection drug use, imprisonment, tattooing, having more than one sexual partner, piercing, and having only secondary education were associated with increased odds of hepatitis C.
丙型肝炎感染是一个全球性的公共卫生问题。本研究旨在确定马来西亚吉打州成年患者丙型肝炎感染的相关危险因素。在一家三级医院进行了一项匹配的、基于医院的病例对照研究。病例为 2015 年 1 月至 2018 年 12 月丙型肝炎病毒抗体血清学检测结果阳性且可检测到丙型肝炎病毒 RNA 的成年（年龄≥18 岁）患者，对照为年龄、性别和种族匹配且未感染丙型肝炎病毒的患者。研究参与者通过自填问卷收集人口统计学特征和以前接触选定危险因素的资料。使用单变量和多变量逻辑回归分析评估丙型肝炎与人口统计学和危险因素之间的关系。共纳入 255 对病例对照患者。多变量分析表明，1992 年之前有输血或血制品史（调整后比值比 [AOR] = 6.99，95%置信区间 [CI]：3.73-13.81）、注射吸毒（AOR = 6.60，95% CI：3.66-12.43）、监禁（AOR = 4.58，95% CI：1.62-16.40）、纹身（AOR = 3.73，95% CI：1.37-12.00）、有多个性伴侣（AOR = 2.06，95% CI：1.16-3.69）、穿孔（AOR = 1.71，95% CI：1.04-2.80）和仅有中等教育（AOR = 1.92，95% CI：1.06-3.57）与丙型肝炎独立相关。医疗保健职业、针刺伤、手术、血液透析、针灸、拔罐或接触性运动与丙型肝炎感染之间没有关联。这些发现表明，丙型肝炎的风险是多因素的。1992 年之前有输血或血制品史、注射吸毒、监禁、纹身、有多个性伴侣、穿孔和仅有中等教育与丙型肝炎感染的几率增加有关。
