四川省彝族聚居区1～13岁儿童HIV、HBV及HCV感染横断面调查

A survey of HIV, HBV and HCV infections in children aged 1-13 years in Yi ethnic area, Sichuan province

目的 了解四川省彝族聚居区1~13岁儿童HIV、HBV及HCV感染情况。方法 采用横断面调查设计，于2014-2015年在四川省彝族聚居区的4个乡镇开展横断面调查，对1~13岁儿童进行HIV抗体、HBV抗原和HCV抗体筛查，并进行实验室确认，估算调查样本量900人。采用Fisher确切概率法对不同乡镇、性别、年龄和民族的感染率进行比较，Bonferroni调整法进行多个样本感染率的两两比较。结果 共调查了677名1~13岁儿童，HIV、HBV和HCV感染率分别为1.03%（7/677，95%CI：0.42%~1.12%）、6.65%（45/677，95%CI：4.89%~8.79%）和0.15%（1/677，95%CI：0%~0.82%）。4个乡镇的儿童HIV感染率不同（P=0.000）；D乡儿童HIV感染率高于B乡，差异有统计学意义（P〈0.001）。各年龄组、性别和民族儿童间HIV感染率差异无统计学意义。各乡、各年龄组、性别和民族的儿童HBV和HCV感染率差异均无统计学意义。5~9岁和10~13岁年龄组HBV病毒载量值的差异无统计学意义（U=115.000，P=0.967）。结论 四川省彝族聚居区1~13岁儿童存在较高的HIV和HBV感染率，应进一步采取措施遏制HIV和HBV母婴传播，宣传与推广乙肝疫苗接种。

Objective To investigate the prevalence of HIV, HBV and HCV infections in children aged 1-13 years in Yi ethnic area in Sichuan province. Methods A cross-sectional study was conducted in the form of field survey in four townships selected from Yi ethnic area of Sichuan during 2014-2015. Participants were children aged 1-13 years by sample size of 900 and were screened for HIV antibody, HBV surface antigen and HCV antibody, and laboratory comfirmation was conducted. The area, age, gender and ethnic group specific infection rates were compared by using Fisher＇ s exact test, and multiple comparisons were corrected by using Bonferroni correction. Results A total of 677 children aged 1-13 years were surveyed. The infection rates of HIV, HBV and HCV were 1.03% （7/677, 95%CI： 0.42%-1.12%）, 6.65% （45/677, 95%CI： 4.89%-8.79%） and 0.15% （1/ 677, 95% CI： 0%-0.82%）, respectively. The infection rates of HIV differed among townships （P= 0.000）, the infection rate was higher in township D than in township B, the difference was significant （P〈0.001）. The differences in HIV infection rate among different age, gender and ethnic groups were not significant. The differences in HBV and HCV infections were not significant among different townships, age, gender and ethnic groups. The difference in HBV viral load between age group 5-9 years and age groups 10-13 years was not significant （U=l15.000, P=0.967）. Conclusions The burden of HIV and HBV infections in children aged 1-13 years was heavy in rural area of Yi ethnic area in Sichuan. Therefore, it is necessary to take effective measures to block the vertical transmission of HIV and HBV as well as to increase the coverage of HBV vaccination.