2013—2022年云南省11类人群丙型肝炎抗体检测结果分析

Hepatitis C virus antibody testing among 11 specific populations in Yunnan province from 2013 to 2022:an analysis of annual report data from medical institutions

目的了解和掌握云南省11类人群丙型肝炎病毒(HCV)性肝炎(丙型肝炎)的流行水平、流行趋势,为制订防治措施和评估防治效果提供依据。方法收集2013—2022年云南全省16个州(市)医疗卫生机构填报的丙型肝炎综合防治信息年度报表数据,采用R软件Cochran–Armitage趋势性检验分析不同人群、不同地区抗–HCV阳性率变化趋势。结果全省累计进行抗–HCV检测64879772人份,阳性392971人份,阳性率为0.61%。2013—2022年抗–HCV阳性率为0.49%(45069/9286175)~0.83%(20819/2494869),阳性率呈下降趋势(Z=–100.05,P<0.05)。阳性率排前3位的人群分别为吸毒人群27.46%(52508/191184)、羁押人员3.31%(3183/96038)和暗娼人群0.92%(1152/125832),除婚检人群和男男性行为人群抗–HCV阳性率呈上升趋势(Z=2.9252,P<0.05;Z=7.0807,P<0.05)外,其余8类人群(输血前检查、其他就诊者、孕产妇、献血人群、吸毒人群、暗娼、羁押人员、其他人员)均呈下降趋势(P<0.05);阳性率排前3位的地区分别为德宏州、保山市、红河州和昆明市,除迪庆州、怒江州和昭通市抗–HCV阳性率呈上升趋势(Z=3.518,P<0.05;Z=7.2602,P<0.05;Z=4.5373,P<0.05)外,其余12个州(市)均呈下降趋势(P<0.05)。结论云南省2013—2022年抗–HCV阳性者分布多集中于吸毒、羁押和暗娼等重点人群,地区分布多集中在德宏州、保山市、红河州和昆明市等地区,且与全省既往吸毒人群分布呈现“相互重叠交织”的现象。

Objective To understand the prevalence level and trend of hepatitis C virus(HCV)among 11 specific populations in Yunnan province,and to provide evidence for formulating and evaluating the effectiveness of prevention and control measures.Methods The annual report data from 2013 to 2022 on comprehensive prevention and control of hepatitis C were collected from all medical institutions in 16 prefectures/municipalities in Yunnan province and were analyzed using R software and the Cochran-Armitage trend test was used to assess the changing trends in HCV antibody(anti-HCV)positivity rates among different population groups and for different regions.Results Of a total of 64879772 person-times of anti-HCV detection performed in medical institutions during the period,392971(0.61%)were anti-HCV positive,and the annual anti-HCV positive rates ranged from 0.49%(45069/9286175)to 0.83%(20819/2494869)during the period,with a decreasing trend(Z=–100.05,P<0.05).The top three population groups with the highest antiHCV positive rate were drug users(27.46%,52508/191184),detainees(3.31%,3183/96038),and female sex workers(0.92%,1152/125832).The anti-HCV positive rate showed a decreasing trend in all population groups,including preoperative patients,blood transfusion recipients,other medical clients,pregnant women,blood donors,drug users,female sex workers,detainees,and others(all P<0.05),except for premarital checkups and men who have sex with men,whose anti-HCV positive rates showed an increasing trend(Z=2.9252,P<0.05;Z=7.0807,P<0.05).The top three regions with the highest anti-HCV positive rate were Dehong prefecture,Baoshan municipality,Honghe prefecture and Kunming municipality.The anti-HCV positive rate showed a decreasing trend in all prefectures/municipalities of the province during the period(all P<0.05),except for in Diqing and Nujiang prefectures and Zhaotong municipality,whose antiHCV positive rate showed an increasing trend(Z=3.518,P<0.05;Z=7.2602,P<0.05;Z=4.5373,P<0.05).Conclusion The prevalence of anti-HCV positive in Yunnan province from 2013 to 2022 was mainly among key populations such as drug users,detainees,and female sex workers,with regions with higher positive rate including Dehong and Honghe prefectures,and Baoshan and Kunming municipalities,where the prevalence of former drug abuse was also higher.