2011-2020 年浙江省温州市吸毒人群丙型肝炎感染状况及其影响因素分析

Prevalence of HCV infection and related risk factors in drug users in Wenzhou,Zhejiang,2011-2020

目的分析浙江省温州市艾滋病监测哨点吸毒人群丙型肝炎(丙肝)感染状况变化趋势及其影响因素。方法2011—2020年每年4—7月,在温州市监测哨点强制戒毒所随机选择约400名吸毒者,采用问卷调查方式,收集吸毒者一般人口学信息、艾滋病相关知识、接受干预服务情况、毒品使用及性行为等信息,并采集血液标本进行丙肝病毒(HCV)的抗体检测。采用多元logistic回归分析HCV抗体检测阳性的影响因素。结果共监测4052名毒品使用者,HCV抗体阳性率平均为41.91%。2011—2013年HCV抗体阳性率平均为54.10%,而2014—2020年HCV抗体阳性率明显下降,平均为36.65%。但是,从2014年开始,HCV抗体阳性率从30.00%上升到2020年的41.50%。年龄≥30岁、浙江省户籍、低学历、传统或混合毒品使用和曾注射毒品是HCV抗体阳性率危险因素,其中,年龄≥30岁、浙江省户籍、传统或混合毒品使用和曾注射毒品可解释2014—2020年HCV抗体阳性率的上升趋势。结论近10年,温州市吸毒人群HCV感染维持在较高水平,呈现先下降,后逐渐上升的趋势,推测前期HCV感染水平的降低可能与丙肝诊治水平提高有关。而近期HCV感染水平的升高则是吸毒人群特征和毒品使用类型或方式的改变所致。

Objective To understand the prevalence of hepatitis C and related risk factors in drug users under sentinel surveillance in Wenzhou during 2011-2020 and provide evidence for the prevention and control of hepatitis C in this population.Methods A consecutive cross-sectional survey with standard questionnaire was conducted in about 400 drug users randomly selected in compulsory detoxification settings for the annual sentinel surveillance between April and July during 2011-2020,and basic demographic information and blood samples were collected from them.Multivariate logistic regression model was used to analyze the related risk factors of HIV infection.Results A total of 4052 drug users were included in the analysis,the prevalence rate of HCV infection was 41.91%.The average positive rate of HCV antibody was 54.10%during 2011-2013,and 36.65%during 2014-2020.However,the positive rate of HCV antibody increased from 30.00%in 2014 to 41.50%in 2020.Multivariate logistic regression analysis indicated HCV infection risk factors included age≥30 years,living in Zhejiang,low education level,being traditional drug user or mixed drug user and injecting drug use.Among them,age≥30 years,living in Zhejiang,being traditional drug user or mixed drug user and injecting drug use can explain the rise of HCV antibody positive rate from 2014 to 2020.Conclusion In the past 10 years,the prevalence of HCV infection in drug users in Wenzhou remained at a high level,showing a significant decline firstly and then a gradual rise.It is speculated that the early decrease of HCV infection level might be related to the improvement of the diagnosis and treatment of Hepatitis C,but the recent increase of HCV infection level is caused by the changes in the characteristics of drug users and the types or modes of drug use.