浙江省丙型病毒性肝炎血清流行病学调查:一项基于医院的研究

Seroepidemiologieal investigation of hepatitis C virus in Zhejiang Province:a hospital-based study

目的研究浙江省当前丙型肝炎病毒的抗体(抗-HCV)水平和分布特点。方法采用分层整群随机抽样方法。采集调查点医院中调查人群的血清,检测抗-HCV,并分析比较不同性别、地区、年龄段之间HCV感染率。率的比较采用χ^2检验。结果浙江省平均抗-HCV阳性率为0.24%[95%可信区间(CI)为0.16%~0.32%]。其中平原地区的抗-HCV阳性率为0.32%(95%CI:0.19%~0.45%),明显高于沿海海岛的0.05%(95%CI:0~0.12%,χ^2 = 7.638, P<0.05);与丘陵地区0.22%(95%CI:0.03%~0.41%)相比,差异无统计学意义。男性和女性之间的抗-HCV阳性率差异无统计学意义(χ^2=2.238,P=0.135)。总人群56~60岁为最高抗-HCV阳性率的年龄段(0.93%),<20岁的抗-HCV阳性率最低。相比2006年的中国丙型肝炎血清流行病学研究结果,2017年各年龄组的抗-HCV阳性率均低于之前的水平。结论浙江省属于低抗-HCV阳性率地区,且较10年前进一步下降。平原地区抗-HCV阳性率高于海岛。中老年是流行高发的年龄段,20岁以下人群抗-HCV阳性率极低。性别对抗-HCV阳性率影响不大。

ObjectiveTo study serum HCV antibody (anti-HCV) with geographic distribution characteristics in Zhejiang Province.MethodsA stratified random cluster sampling method was used. Serum samples of the surveyed population were collected from selected hospitals, anti-HCV antibodies were examined, then hepatitis C infection rates among different genders, regions and age groups were analyzed. The anti-HCV rate was compared using the χ^2 test.ResultsThe average anti-HCV positive rate in Zhejiang Province was 0.24% [95% confidence interval (CI): 0.16% ~ 0.32%]. The antibody positive rate in the plain area was 0.32% (95% CI: 0.19% ~ 0.45%), which was significantly higher than the coastal islands 0.05%(95% CI: 0.00%~0.12%, χ^2 = 7.638, P<0.05). There was no significant difference between plain area and hilly area 0.22% (95% CI: 0.03% - 0.41%). There was no statistically significant difference in anti-HCV positive rates between males and females (χ^2=2.238, P=0.135). The highest positive rate of anti-HCV (0.93%) was in the population aged 56-60 years and the lowest in the population aged less than 20 years. Anti-HCV positive rate of all age groups in 2017 was lower than that of 2006 seroepidemiological study of hepatitis C.ConclusionZhejiang Province is a region with low anti-HCV positive rate and the disease prevalence further reduced than 10 years ago. The positive rate of anti-HCV in plain areas is higher than islands. Middle-aged and elderly people are the age group with high prevalence, and the anti-HCV positive rate in people under 20 years old is exceptionally low. Gender differences in anti-HCV positive rate have little effect.