河南省某农村丙型肝炎病毒感染的随访研究

Follow-up studies of hepatitis C virus infection in a rural population in Henan province

为了解自然人群中丙型肝炎病毒（HCV）感染状况及其危险因素，于1994年三月对河南省某农村进行了HCV感染的横断面调查，并于其后第8和第14个月进行了2次随访调查。结果表明，1994年1月该人群抗-HCV阳性率为26．6％（164／692），其中．有献浆史者抗-HCV阳性率（86．6％），显著高于无献浆史者（3．2％，P＜0．01）;献浆次数，年限与抗-HCV阳性率之间存在正效应剂量反应关系（P＜0．01）。随访期间，有献浆史者HCV的新感染率（22．6％）显著高于无献浆史者（0．2％，RR=95．0，P＜0．01）；一方为抗-HCV阳性的配偶的HCV新感染率（11．1％）较双方均为抗-HCV阴性的配偶（3．5％：）高3倍以上（RR=3．22，P＞0．05）；3名新感染者与其配偶（原为HCVRNA阳性）的HCV基因型一致且其中1名新感染者无经血暴露史，提示经性传播的可能。该人群拉-HCV年阴转率为1．0％，年阳转率为1．6％；27．5％～41．6％的HCV感染者伴有ALT异常。结论：献血浆是当地人群HCV感染的主要危险因素并可能存在性传播。

To investigate the prevalence and risk factors of hepatitis C virus (HCV) infection, a cross-sectional survey was conducted in some rural population in Henan province in January, 1994, with two follow-up studies undertaken 8 and 14 months later. The prevalence of anti-HCV antibody was 26. 6% (164/692) in the population,and it was significantly higher in plasma donors (86. 6%) than that in People without history of plasma donation (3.2%, P＜0.01) Longer duration and more times of plasma donation were both strongly associated with positive anti-HCV (P＜0. 01). Seroconversion to anti-HCV was observed in 22. 6% of plasma donors compared with 0. 2% of those without history of plasma donation (RR=95. 0, P＜0.01). The incidence of HCV infection in subjects whose spouses were anti-HCV positive was more than three times higher as compared with those of anti-HCV negative spouses (P＞0.05). Among the 3 subjects who acquired HCV infection during the follow-up period and had the same HCV geotype with their spouses, one had no history of plasma donation, suggesting the possibility of sexual transmission between spouses. The positive seroconversion rate of anti-HCV was 1. 6% per year, while the negative seroconversion rate of anti-HCV was 1.0% per year in the population. 27. 5%～41. 6% of the subjects with HCV infection had ALT elevation. In conclusion,plasma donation was the major risk factor of HCV infection in the population, and sexual transmission of HCV between spouses was possible.