2947例结核(TB)患者丙型肝炎病毒抗体检测结果分析

Hepatitis C antibody test results: Analysis of 2 947 patients with tuberculosis(TB)

2007年10月～2011年12月本院收治2 947例结核病患者,丙型肝炎血清学检测显示,患者抗-HCV阳性69例,阳性率2.34%。其中男性阳性率3.17%(42/1323),女性为1.66%(27/1624),男性HCV阳性率显著高于女性(χ2=7.28,P<0.01)。结核确诊病例、结核临床诊断病例和结核疑似病例HCV阳性率分布为3.03%、1.91%和1.71%,差异无统计学意义(χ2=2.93,2.89,P>0.05)。7岁～、20岁～、40岁～及60岁以上人群HCV阳性率分别为0.69%、1.93%、3.92%和1.19%,差异有统计学意义(χ2=6.75,P<0.01)。结核患者HCV感染率与一般人群相同,并不是HCV感染高危人群。新发结核病人,特别是40岁以上患者,在抗结核治疗前均应常规检测抗HCV抗体以除外合并HCV感染,可有效减少抗结核药的肝毒反应。

Hepatitis C serology tests for 2 947 patients with tuberculosis at this hospital from Oct. 2007 to December 2011 revealed that 69 patients were positive for anti-HCV at a rate of 2.34%. Positivity was 3.17% （42/1323） for males and 1.66% （27/1624） for females, so men were significantly more HCV-positive than females （χ2 = 7.28,P〈0.01）. Positivity for HCV was 3.03% in confirmed cases of tuberculosis, 1.91% in clinically diagnosed cases of tuberculosis, and 1.71% in suspected cases of tuberculosis; the difference in positivity was not statistically significant （χ2 =2. 93, 2.89,P〉0.05）. Positivity for HCV was 0.69% in patients age 7 and over, 1.93% in those age 20 and over, 3.92% in those age 40-year-old and 1.19% in those age 60 and over; the difference was statistically significant （χ2 = 6.75, P% 0.01）. Patients with tuberculosis had the same rate of HCV infection as the general population and were not a group with a high risk of HCV infection. New patients with tuberculosis, and especially patients over the age of 40, should be routinely testing for anti-HCV antibodies before anti-TB treatment to exclude HCV infection. This should effectively reduce the liver toxicity of anti-TB drugs.