Qu L X, Shi Y, Chen K Y, Wang W, Ren H
Shanghai Municipal Center for Disease Control & Prevention, Shanghai 200336, China.
Shanghai Municipal Center for Disease Control & Prevention, Shanghai 200336, China Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education Fudan University, Shanghai 200032, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Apr 10;42(4):626-631. doi: 10.3760/cma.j.cn112338-20200802-01009.
The purpose of this study is to analyze the surveillance data of the Integrated HCV surveillance in Shanghai and provide a scientific basis for HCV's elimination strategies. Descriptive statistical analysis and multivariate logistic regression analysis were performed using the multi-dimension results of the Integrated HCV surveillance in Shanghai from 2014 to 2019. Data related to reported HCV cases, HCV gene subtypes surveillance, HCV behavioral risk factors surveillance and HCV-antibody testing results of the community-based general population and high-risk/key populations. The reported incidence rate of acute hepatitis C in Shanghai decreased from 2014 to 2019 (=-4.07, <0.01); meanwhile, the reported incidence rate of chronic hepatitis C met an upward trend (=10.26,<0.01), with an annual average, reported incidence rates of 0.18 per 100 000 and 8.60 per 100 000, respectively. Seven hundred forty-four blood samples were subtyped with 16 subtypes from 4 genotypes (GT1, GT2, GT3, and GT6). Among above, 1b (324 cases, 43.55%), 3a (121 cases, 16.26%), 3b (111 cases, 14.92%) and 6a (47 cases, 6.32%) were the principal subtypes. The composition of genotypes varied with decreased 1b and increased 3b and 6a. The major risk factors for HCV infection were blood transfusion (=4.18, 95%: 2.79-6.27), surgery (=1.63, 95%: 1.26-2.12), sharing syringe (=4.18, 95%: 2.75-6.34), pedicure (=2.01, 95%: 1.54-2.62), sharing razors (=4.09, 95%:1.24-13.51), and unsafe beauty practices (=3.15, 95%: 2.13-4.65). HCV antibody screening of 11 groups of high-risk/key populations showed that drug users had the highest HCV-antibody positive rate of 18.81% (1 008/5 358). The anti-HCV positive rate of the general population was 0.16% (7/4 268), which was significantly lower than that of high-risk/key populations from the same year, 2.50%(501/20 002) (=94.04, <0.01). Shanghai is a low-endemic area of HCV. Constantly carrying out integrated surveillance and analysis is of great value for early identification of HCV infected people and its risk factors, timely adjustment of prevention and control strategies, and eliminating the public health threat of HCV.
本研究旨在分析上海市丙型肝炎综合监测的监测数据，为丙型肝炎消除策略提供科学依据。利用2014年至2019年上海市丙型肝炎综合监测的多维度结果进行描述性统计分析和多因素logistic回归分析。数据涉及报告的丙型肝炎病例、丙型肝炎基因亚型监测、丙型肝炎行为危险因素监测以及社区普通人群和高危/重点人群的丙型肝炎抗体检测结果。上海市急性丙型肝炎报告发病率从2014年至2019年呈下降趋势（=-4.07，<0.01）；与此同时，慢性丙型肝炎报告发病率呈上升趋势（=10.26，<0.01），年平均报告发病率分别为每10万人口0.18例和8.60例。744份血样被分为4个基因型（GT1、GT2、GT3和GT6）中的16个亚型。其中，1b型（324例，43.55%）、3a型（121例，16.26%）、3b型（111例，14.92%）和6a型（47例，6.32%）为主要亚型。基因型组成随1b型减少、3b型和6a型增加而变化。丙型肝炎感染的主要危险因素为输血（=4.18，95%可信区间：2.79-6.27）、手术（=1.63，95%可信区间：1.26-2.12）、共用注射器（=4.18，95%可信区间：2.75-6.34）、修脚（=2.01，95%可信区间：1.54-2.62）、共用剃须刀（=4.09，95%可信区间：1.24-13.51）和不安全美容行为（=3.15，95%可信区间：2.13-4.65）。对11组高危/重点人群进行丙型肝炎抗体筛查显示，吸毒者丙型肝炎抗体阳性率最高，为18.81%（1008/）。普通人群抗-HCV阳性率为0.16%（7/4268），显著低于同年高危/重点人群的2.50%（501/20002）（=94.04，<0.01）。上海是丙型肝炎低流行地区。持续开展综合监测与分析对于早期识别丙型肝炎感染者及其危险因素、及时调整防控策略以及消除丙型肝炎的公共卫生威胁具有重要价值。 （注：原文中部分数据处有缺失，已用表示）
