中国2010-2012年丙型肝炎哨点5类监测人群HCV感染状况分析

Analysis on HCV prevalence among 5 kinds of populations in HCV sentinel surveillance during 2010-2012 in China

目的了解丙型肝炎（丙肝）哨点5类监测人群（肾透析人群、无偿献血人群、医院侵入性诊疗人群、单位体检检群、计划生育门诊就诊人群）丙肝病毒（HCV）感染状况及趋势，为丙肝综合防治和科学干预提供信息和依据。方法2010-2012年，在每年46月，使用连续性监测方法收集5类监测人群的血样，完成HCV抗体的实验室检测，并进行描述和分析。结果20102012年，5类监测人群中，肾透析人群哨点HCV抗体阳性率（均数）均超过5％（0-25．3％）；医院侵入性诊疗人群HCV阳性率为0．7％～0．9％；除2010年无偿献血人群HCV抗体阳性率为0．6％外，其他年份单位体检人群、无偿献血人群、计划生育门诊就诊人群的HCV抗体阳性率均低于0．5％。结论肾透析人群的感染率持续处于较高水平，而其他丙肝哨点监测人群HCV抗体阳性率较低。血液传播是目前中国HCV传播的主要途径，如何避免或降低HCV传播的风险，是当前和今后应当重视和亟待解决的问题。

Objective To analyze the prevalence of hepatitis C virus （HCV） among 5 kinds of populations in HCV sentinels during 2010--2012, in order to provide information for evaluation on strategies regarding comprehen- sive HCV prevention and effectiveness of intervention. Methods Cross-sectional studies had been repeatedly con- ducted in sentinels with collection of venous blood specimen among the target population from April to June annually during 2010--2012, and the HCV antibodies were tested. Results The overall HCV prevalence （mean） of patients on hemodialysis was over 5% from 2010 to 2012, and the separated sentinel rate ranged from 0.0% to 25.3%; HCV positive rate of patients undergoing invasive treatment ranged from 0.7 % to 0.9 %; in addition to volunteer blood donors in 2010 whose HCV positive rate was 0.6%, the HCV positive rates of other population including physical examination people, family planning clinic attendees and volunteer blood donors were less than 0.5% in 2011 and 2012. There was no significant difference between male and female on HCV infection in 5 kinds of popula- tion of HCV sentinel surveillance （P〈0.01）. Conclusion HCV prevalence of patients on hemodialysis maintain a high level, other populations with history of invasive diagnosis, treatment, and blood donation in HCV sentinel sur- veillance, of which HCV prevalence were relatively low. Blood-borne spread of HCV is the main HCV transmission route in China, and it is important to avoid or reduce the risk of HCV transmission.