某HCV暴发地区非肝炎就诊人群肝炎病毒感染与暴发疫情关联分析
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摘要
目的对某HCV疫情暴发地区医院非肝炎就诊人群肝炎病毒感染状况及其肝功能状况进行分析,探索该人群抗-HCV阳性率与当地疫情间的关联。方法收集疫情暴发期间曾到某医院就诊的非肝炎就诊人群丙肝抗体(抗-HCV)、乙肝病毒标志物(HBV-M)及ALT等相关检测结果,并对结果进行分析。结果 164例就诊者的检测结果中,33. 5%的就诊者(55/164)抗-HCV(+),其中10. 9%的就诊者(6/55)合并HBs Ag(+); ALT结果 > 40 U/L的抗-HCV(+)就诊者占59. 2%;不同性别及年龄的就诊者HCV/HBV感染情况、ALT检测结果以及不同HBV/HCV感染状态就诊者间ALT检测结果的差异均无统计学意义(χ~2=4. 983,P=0. 079)。结论某医院就诊人群中抗-HCV阳性率与暴发疫情是否关联尚不明确,应作进一步的工作(HCV-RNA检测、流行病学资料补充等)对该地区疫情状况进行推断。
Objective To analyze the hepatitis virus infection status and liver function status of non-hepatitis patients in a HCV outbreak area,and to explore the relationship between the anti-HCV positive rate and the local epidemic. Methods Anti-HCV,HBV-M and ALT testing results of non-hepatitis patients who had visited the hospital during the outbreak were collected to analyze the situation. Results A total of 164 testing results were collected. 33. 5% cases were anti-HCV( +)( 55/164),among those cases,6 cases( 10. 9%) were combined with HBs Ag( +); 59. 2% cases' ALT results were higher than 40 U/L; the HCV/HBV infection status and ALT testing results' difference were not significant between different gender and age cases; there were no significant difference in the ALT testing results between different HCV/HBV infection status cases( χ~2=4. 983,P = 0. 079). Conclusion High positive rate of the hospital treatment population was undefined associated with the HCV epidemic. The HCV confirmatory testing should be taken by HCV RNA testing.
Objective To analyze the hepatitis virus infection status and liver function status of non-hepatitis patients in a HCV outbreak area,and to explore the relationship between the anti-HCV positive rate and the local epidemic. Methods Anti-HCV,HBV-M and ALT testing results of non-hepatitis patients who had visited the hospital during the outbreak were collected to analyze the situation. Results A total of 164 testing results were collected. 33. 5% cases were anti-HCV( +)( 55/164),among those cases,6 cases( 10. 9%) were combined with HBs Ag( +); 59. 2% cases' ALT results were higher than 40 U/L; the HCV/HBV infection status and ALT testing results' difference were not significant between different gender and age cases; there were no significant difference in the ALT testing results between different HCV/HBV infection status cases( χ~2=4. 983,P = 0. 079). Conclusion High positive rate of the hospital treatment population was undefined associated with the HCV epidemic. The HCV confirmatory testing should be taken by HCV RNA testing.
引文
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[2]THOMAS DL.Global control of hepatitis C:where challenge meets opportunity[J].Nature Medicine,2013,19(7):850-858.
[3]付笑冰,林鹏,李艳,等.广东省2005-2013年丙型病毒性肝炎流行特征分析[J].华南预防医学,2015,41(5):435-438.
[4]陈园生,李黎,崔富强,等.中国丙型肝炎血清流行病学研究[J].中华流行病学杂志,2011,32(9):888-891.
[5]WHO.Prevention and Control of Viral Hepatitis Infection:Framework for Global Action[Z].2012.
[6]黄东升,郑维斌,杨家芳,等.保山市HIV哨点吸毒人群HCV感染现状及相关影响因素分析[J].中国艾滋病性病,2013,19(4):279-282.
[7]王瑞,王学良,李恒新,等.西安市吸毒人群HCV感染状况及影响因素分析[J].中华疾病控制杂志,2015,19(12):1252-1254,1268.
[8]贺林华,周志强.美沙酮替代治疗者乙型肝炎病毒、丙型肝炎病毒感染情况及其基因型的流行情况分析[J].中国现代医学杂志,2016,26(21):62-67.
[9]张瑞,李金明.丙型肝炎病毒感染临床检测程序的建立及结果报告与解释[J].中华检验医学杂志,2010,33(10):990-992.
[10]中华人民共和国卫生部.WS 213-2018丙型病毒性肝炎诊断标准[S].北京:中国标准出版社,2018.
[11]陈卿,石璟,冯永亮,等.血液透析者乙肝和丙肝感染情况及影响因素分析[J].中国公共卫生,2013,29(11):1577-1580.
[12]黄海樱,陈波,周强,等.广州地区乙型肝炎与丙型肝炎病毒感染血清学检测的流行病学调查研究[J].中华医院感染学杂志,2016,26(10):2260-2263.
[13]马征,李杨.丙肝病毒与乙肝病毒重叠感染几率观察[J].临床和实验医学杂志,2011,10(11):821-822.
[14]邵芳.HCV抗原、HCV抗体及HCV-RNA联合检测与ALT的相关性及其临床意义[J].中国中西医结合消化杂志,2014,22(2):80-82.
[15]唐筛娣,王佳佳,王洁,等.有偿献血人群血浆雌二醇与HCV感染及肝功能情况关系的研究[J].中华疾病控制杂志,2013,17(7):553-556.