长春市吸毒人群HCV感染状况及肝纤维化程度调查

Investigation on the incidence rate of hepatitis virus C infection and progress of hepatic fibrosis among drug users in Changchun city

目的了解长春市吸毒人群中HCV感染状况及HCV求医行为,评价长春市吸毒人群HCV感染者肝纤维化进展程度及其危险因素,为指导长春市丙肝防治工作的开展提供依据。方法于2016年11~12月在长春市的戒毒所和美沙酮门诊,现场调查了133名吸毒人员,并对其进行采血来进行实验室检测。结果被调查的吸毒人员共133人,平均为(36. 980±9. 365)岁; HCV抗体阳性患者共检出26人(19. 5%);被调查吸毒人群知道丙肝的占36. 8%; 9. 0%的吸毒人员吸毒方式为注射、18. 2%共用过针具、60. 9%在过去一年偷吸过毒、36. 1%发生过无保护性行为;抗体阳性者接受丙肝治疗率低,未接受治疗主要是因为经济困难;丙肝抗体阳性者中怀疑肝硬化(APRI> 2)的共4人,占15. 4%;民族、是否知晓非正规口腔治疗史是否可能感染丙肝、是否知道肝纤维化、是否知晓肥胖是否会加速肝纤维化及肝硬化、是否饮酒的APRI指标差异具有统计学意义(P均<0. 05),HCV阳性患者中4(15. 4%)人怀疑肝硬化。结论长春市吸毒人群HCV感染情况较重,且丙肝相关知识知晓情况较差、高危行为情况有待改善,HCV阳性患者的纤维化程度相对较好。应加大宣传和健康教育力度,采取相应的干预措施,降低吸毒人群患丙肝的概率,提高治疗率,从而改善患者的预后。

Objective To investigate the status and care seeking behavior among drug users with hepatitis virus C（HCV） infection, and evaluate the progress and risk factor of hepatic fibrosis in this group in Changchun city for evidence to plan preventive measures for HCV. Methods By field investigation, we randomly recruited 133 drug users from the bureau of drug abuse control and methadone maintenance therapy clinic in Changchun city from November 2016 to December 2016. Blood samples were obtained from those subjects, and tested in laboratory. Results In the 133 drug users, the average age was （36. 980 ± 9. 365） years, and 26 subjects were detected with HCV infection（ 19.5% ）. Only 36.8% had learnt that they were infected with hepatitis C. 9.0% drug users depended on injection, and 18.2% shared injection with other users. 60.9% disclosed secret drug use in the past one year, and 36.1% confessed that they had unprotected sexual activities. Very small number of the drug users with hepatitis C had ever received therapy because of poorer affordability. Four patients with hepatitis C were suspected to have cirrhosis （APRI 〉 2） （15.4%）. The difference was significant concerning the ethnics, awareness of hepatitis C infection from dental work in illegal clinic, knowledge of hepatic fibrosis and fat potentially increasing liver fibrosis and cirrhosis as well as APRI being associated with alcohol intake（ all P 〈 0.05 ）. Of the patients with positive HCV, 4（ 15.4% ） were suspected of cirrhosis. Conclusion HCV infection appears more serious among drug users in Changchun area. This population group have poorer knowledge on hepatitis C. Although the high - risk behavior needs improving, yet the incidence of liver fibrosis is relatively moderate in patients with positive HCV. Health education and corresponding inventions should be enhanced in the drug users in order to reduce their hepatitis C prevalence, yet improve the treatment and prognosis.