2010-2020年中国注射吸毒人群和非注射吸毒人群丙型肝炎抗体阳性率的Meta分析

HCV antibody positivity rates among injection and non-injection drug users in China from 2010 to 2020:a metaanalysis

目的对我国注射吸毒人群(IDUs)和非注射吸毒人群(non-IDUs)丙型肝炎(简称丙肝)病毒抗体(简称抗-HCV)阳性率进行Meta分析,为该人群丙肝防治提供科学依据。方法系统检索PubMed、Web of Science、Embase、Scopus、CNKI、万方数据库和SinoMed中2010年1月1日至2023年10月1日发表的我国IDUs和non-IDUs抗-HCV阳性率的研究。对检索到的文献进行筛选、评价并提取数据,运用RStudio 4.1.0软件进行统计分析,按地区、来源和研究年份进行亚组分析,利用Egger检验评估发表偏倚。结果本研究共纳入38篇文献,覆盖23个省(自治区、直辖市),IDUs和non-IDUs样本量分别为37053人和60689人。Meta分析结果显示,2010-2020年我国IDUs和nonIDUs抗-HCV阳性率分别为66.9%(95%CI:59.0%~74.3%)和20.4%(95%CI:15.3%~26.0%),差异有统计学意义(P<0.05)。IDUs和non-IDUs抗-HCV阳性率均在西南地区最高,为82.5%和32.2%,均在华中地区最低,为40.2%和8.8%。不同调查来源和不同年份分组的IDUs及non-IDUs的抗-HCV阳性率差异无统计学意义(P>0.05)。时间亚组分析结果显示,2010-2015年和2016-2020年我国IDUs的抗-HCV阳性率为68.2%和65.0%,non-IDUs的抗-HCV阳性率为20.5%和27.1%,差异无统计学意义(P>0.05)。结论我国IDUs和non-IDUs抗-HCV阳性率高,需要采取措施减少该人群的HCV传播,提高HCV感染者检测发现和治疗率,减少该人群丙肝疾病负担。

Objective A meta-analysis was conducted to provide the prevalence of hepatitis C virus(HCV)antibody(anti-HCV)positivity among injection drug users(IDUs)and non-injection drug users(non-IDUs)in China,offering scientific evidence for the prevention and treatment of these populations with hepatitis C.Methods A systematic retrieval was conducted for literature published between January 1,2010,and October 1,2023,in databases including PubMed,Web of Science,Embase,Scopus,China National Knowledge Internet(CNKI),Wanfang Data Knowledge Service Platform and SinoMed that reported on the anti-HCV positivity rates among IDUs and non-IDUs in China.Relevant literature was screened,assessed,and data were extracted.Statistical analysis was performed using RStudio 4.1.0.Subgroup analyses were applied by region,source,and study year.Publication bias was evaluated using the Egger's test.Results A total of 38 articles were included,covering 23 provinces(autonomous regions and municipalities)with sample sizes of 37053 IDUs and 60689 non-IDUs.The meta-analysis showed that from 2010 to 2020,the anti-HCV positivity rates were significantly higher among IDUs(66.9%,95%CI:59.0%-74.3%)than non-IDUs(20.4%,95%CI:15.3%-26.0%)(P<0.05).The highest prevalence rates for both IDUs and non-IDUs were in the southwestern regions,with 82.5%and 32.2%,respectively;while the lowest were in central China,with 40.2% and 8.8%,respectively.No significant difference was found in the anti-HCV positivity rates among different sources of studies and between different years for both IDUs and non-IDUs(P>0.05).Conclusions The high anti-HCV positivity rates among IDUs and non-IDUs in China indicate a need for measures to reduce HCV transmission,improve the detection and treatment rates of HCV infection,and decrease the burden of hepatitis C disease in these groups.