School of Microbiology, University of Antioquia, Medellín, Antioquia, Colombia.
Internal Medicine Infectious Diseases Section, University of Antioquia, Medellín, Antioquia, Colombia.
PLoS One. 2020 Sep 22;15(9):e0238655. doi: 10.1371/journal.pone.0238655. eCollection 2020.
Both hepatitis B virus (HBV) and hepatitis C virus (HCV) are major sources of morbidity and mortality worldwide; however, their prevalence in key groups in Colombia is not yet known. We aimed to analyse the prevalence of HBV and HCV and its associated factors in key groups who were treated at an institution providing health services in Colombia during 2019. This was a multiple-group ecological study that included 2,624 subjects from the general population, 1,100 men who have had sex with men (MSM), 1,061 homeless individuals, 380 sex workers, 260 vulnerable young people, 202 drug users, 41 inmates and 103 people from the lesbian, gay, bisexual and transgender community. Prevalence of infection with a 95% confidence interval and its associated factors was calculated for each group. Confounding variables were assessed using logistical regression and SPSS 25.0 software. Prevalence of HBV and HCV in the general population was 0.15% and 0.27%, respectively; 0.27% and 2.09% in MSM; 0.37% and 2.17% amongst homeless individuals; 0.26% and 0.0% amongst sex workers; 0.39% and 0.0% amongst vulnerable youth; and 5.94% and 45.54 amongst injecting drug users. In the multivariate HBV model, the explanatory variables included the study group, city of origin and the type of health affiliation; for HCV they were group, origin, sex, age group, health affiliation, use of drugs and hallucinogen use during sexual intercourse. A high prevalence of HBV and HCV were evidenced for both viral infections, which was, consequently, much higher within the key groups. The main associated factors that were identified related to origin and type of health affiliation and demonstrated a double vulnerability, that is, belonging to groups that are discriminated and excluded from many health policies and living under unfavourable socioeconomic conditions that prevent proper affiliation and health care.
乙型肝炎病毒 (HBV) 和丙型肝炎病毒 (HCV) 均是全世界发病率和死亡率的主要原因；然而，它们在哥伦比亚关键人群中的流行情况尚不清楚。我们旨在分析 2019 年在哥伦比亚一家提供卫生服务的机构接受治疗的关键人群中 HBV 和 HCV 的流行情况及其相关因素。这是一项多群组生态研究，共纳入 2624 名普通人群、1100 名男男性行为者 (MSM)、1061 名无家可归者、380 名性工作者、260 名弱势青年、202 名吸毒者、41 名囚犯和 103 名男女同性恋、双性恋和跨性别社区成员。为每个群体计算了感染率及其 95%置信区间和相关因素。使用逻辑回归和 SPSS 25.0 软件评估混杂变量。普通人群中 HBV 和 HCV 的感染率分别为 0.15%和 0.27%；MSM 分别为 0.27%和 2.09%；无家可归者分别为 0.37%和 2.17%；性工作者分别为 0.26%和 0.0%；弱势青年分别为 0.39%和 0.0%；注射吸毒者分别为 5.94%和 45.54%。在 HBV 的多变量模型中，解释变量包括研究组、原籍地和健康关联类型；HCV 的解释变量包括组、原籍地、性别、年龄组、健康关联、药物使用和性交时使用迷幻剂。两种病毒感染均表现出高流行率，在关键人群中更高。确定的主要相关因素与原籍地和健康关联类型有关，表现出双重脆弱性，即属于受到歧视和被许多卫生政策排斥的群体，以及生活在不利的社会经济条件下，无法适当获得健康保健。
