山西省强制戒毒者HBV感染状况及影响因素分析

Study on HBV infection and related factors among drug users in compulsory detoxification centers in Shanxi Province

目的 了解山西省强制戒毒者乙型肝炎病毒（hepatitis B virus,HBV）感染状况,初步探讨强制戒毒者HBV感染的影响因素。方法 于2014年6月~12月对山西省3所强制戒毒所1176名强制戒毒者进行面对面问卷调查,收集一般人口学特征、HBV感染的可能影响因素等资料;同时采集静脉血5ml,采用酶联免疫吸附（enzyme linked immunosorbent assay,ELISA）法检测HBsAg和抗-HBs。用非条件Logistic回归模型分析HBV感染的影响因素,并对分析出的危险因素进行交互作用分析。结果 1176名强制戒毒者年龄范围为18~65岁,年龄均数为（37.91±8.58）岁,其中男性1118人,女性58人;HBsAg、抗-HBs的阳性率分别为4.68%（55/1176）、34.69%（408/1176）。Logistic回归分析显示,乙肝家族史（OR=6.654,95%CI：2.550~17.364）、修脚史（OR=1.955,95%CI：1.086~3.518）和丙型肝炎史（OR=7.935,95%CI：1.496~42.098）是HBV感染的危险因素,血清抗-HBs阳性是HBV感染的保护因素（OR=0.125,95%CI：0.044~0.359）。修脚史和乙肝家族史之间未发现相加及相乘交互作用（均有P〉0.05）。结论 强制戒毒人群是HBV感染的高危人群,乙肝家族史、丙型肝炎史和修脚史是该人群HBV感染的危险因素,对该人群应加强乙肝疫苗接种,并采取针对性的干预措施。

Objective To understand the seroepidemiological status of hepatitis B virus （HBV） and its vaccina- tion coverage, and to preliminarily explore the influencing factors of HBV infection among drug users in Shanxi province, China. Methods 1 176 drug users in three compulsory detoxification centers were included in the study, from June to De- cember 2014. Information on the general demographic characteristics, the related factors of HBV infection and history of hepatitis B vaccination were collected through questionnaires at face-to-face interviews. Anticoagulant venous blood samples of 5 ml were also collected for HBsAg and anti-HBs testing, using the enzyme linked immunosorbent assay （ELISA） meth- od. Unconditional logistic regression model was used to analyze the influencing factors of HBV infection. Results A total number of 1 176 drug users were included in the study, including 1 118 males and 58 females, with a mean age of （37. 91 ＋ 8. 58） years. According to the laboratory results, HBsAg positive was defined as the case group （55）, and HBsAg nega- tive was defined as the control group （ 1 121 ）. Age and gender differences between the two groups had no statistically signif- icant differences. The positive rate of HBsAg and anti-HBs were 4. 68% （55/1 176）and 34. 69 % （408/1 176）, respec- tively. 717 subjects （60.97%） were negative for both markers. The coverage rate of hepatitis B vaccination was low, only 22. 62% （266/1 176） of the drug users had a clear history of hepatitis B vaccination. The logistic regression analysis showed that family history of HBV infection （OR =6. 654, 95% CI：2. 550-17. 364）, having pedicure（ OR = 1. 955, 95% CI： 1. 086-3. 518） and history of hepatitis C infection （ OR = 7. 935,95% CI： 1. 496-42. 098 ） were associated with HBsAg positive. Anti-HBs positive was a protective factor of HBsAg positive. Additive interaction and multiplication interaction were not found between pedicure history and family history of HBV infection （ all P 〉 0. 05 ）. Conclusions Drug users in compulsory detoxification centers were high-risk group of HBV infection, and their prior hepatitis B vaccination coverage rate and anti-HBs positive rate were low. Having family history of HBV infection, pedicure experiences and history of hepa- titis C infection were risk factors of HBsAg positive. All above suggest the necessity and importance of the hepatitis B vacci- nation. Thus, the intervention of hepatitis B vaccination could reduce the risk of HBV infection among compulsory detoxifi- cation drug users.