山西省某既往有偿献血地区18～59岁村民丙型肝炎病毒感染的横断面研究

A cross-sectional survey on hepatitis C virus infection among residents aged 18-59 years in a former commercial blood donating community,Shanxi province

目的估计山西省某农村既往有偿献血地区18～59岁村民丙型肝炎病毒(HCV)感染的流行率并分析HCV感染的可能危险因素。方法选择山西省某县12个村庄随机抽取660名18～59岁村民开展以社区为基础的横断面研究。采用标准化问卷收集研究对象的人口学、医疗史、危险行为等信息,采集7 ml静脉血用于检测HCV感染。结果该既往有偿献血地区18～59岁村民总的HCV感染率为8.2%,献血人群HCV感染率为27.7%。多因素logistic回归分析提示,曾经献过血(调整OR=14.28,95%CI:6.83～29.87)和输过血(调整OR=8.66,95%CI:2.31～32.47)是该地村民感染HCV的主要危险因素。对献血亚人群分析发现,曾经献过血浆(调整OR=8.56,95%CI: 2 87～25.54)是献血者感染HCV的最主要危险因素;1994年及以后停止献血的村民感染HCV的危险性较1994年之前停止献血的低(调整OR=0.32,95%CI:0.11～0.93);女性献血者感染HCV的危险性较男性为低(调整OR=0.28,95%CI:0.10～0.83)。结论该献血地区HCV流行水平较高, 既往有偿献血(浆)是该地区HCV流行的最主要原因。应采取有效措施预防该地区居民HCV的二代传播及为阳性患者提供治疗刻不容缓。

Objective To determine sero-prevalence of and risk factors for hepatitis C virus infection （HCV） among residents aged 18-59 years in a former commercial blood donating community, Shanxi province. Methods A community-based cross-sectional survey was conducted among 660 randomly selected residents aged 18-59 years from 12 villages in a rural county of Shanxi province. Structured questionnaire was administered to collect socio-demographic,medical and risk behavioral information. 7 ml-volume venous blood was collected for HCV antibody testing. Results The overall HCV sero-prevalence rates were 8.2 % and 27.7% among former commercial blood donors in the community. Data from multivariate logistic regression analysis showed that people ever selling blood （adjusted OR = 14.28, 95 % CI： 6.83-29.87） and receiving blood transfusion （adjusted OR = 8.66,95% CI： 2.31-32.47） were the primary risk factors for HCV infection. Subgroup analysis in blood donors explored that ever selling plasma （adjusted OR = 8.56,95 % CI： 2.87-25.54） was the risk factor for HCV infection. Villagers who stopped selling blood in 1994 and thereafter were less likely to be HCV positive than those stopping selling blood before 1994 （adjusted OR 0.32,95% CI：0.11-0.93）. Female donors had a lower risk than male ones （adjusted OR 0.28, 95 % CI：0.10-0.83）. Conclusion A HCV epidemic was once existing in rural community residents in the province that former commercial blood/plasma donation was the main reason for HCV epidemic in the community. It is urgent to make efficient measures to prevent HCV secondary transmission and provide patients with care and treatment to this community.