Mode of acquisition of hepatitis C virus infection in patients from southern Hunan province hospitalized with chronic hepatitis C
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摘要: 目的了解湖南地区住院患者中HCV疑似感染方式分布的规律特征,为HCV感染的防治提供参考。方法应用电子病历查询法对住院患者中诊断有丙型肝炎者进行回顾性分析。化学发光法检测抗HCV抗体,实时荧光定量PCR法检测HCV RNA定量。结果肾内科患者主要经血液透析感染(80.0%),妇产科患者主要经手术感染(64.7%),感染科患者主要为输血感染(39.0%)和静脉吸毒感染(28.6%),其他科室患者也主要为输血感染(40.7%)和静脉吸毒感染(37.0%),不同科室住院患者的HCV疑似感染方式构成比存在明显差异(P<0.01)。年龄≤40岁患者主要经静脉吸毒感染(38.2%),而年龄>40岁患者主要经输血感染(49.3%),不同年龄患者HCV疑似感染方式构成比存在明显差异(P<0.01)。男性患者主要经静脉吸毒(35.0%)和输血感染(32.5%),而女性患者主要经手术(32.7%)和输血(26.9%)感染,不同性别患者HCV疑似感染方式构成比存在明显差异(P<0.01)。结论 HCV的感染方式已呈现明显的多样化,静脉吸毒将成为越来越重要的感染因素。Abstract: Objective To investigate the characteristics of hepatitis C virus (HCV) infection mode of acquisition in hospitalized patients with chronic hepatitis C (CHC) , and to provide a reference for designing preventative measures against CHC.Methods The electronic medical records of patients diagnosed with HCV and hospitalized between January 2005 and December 2011 were retrospectively identified and downloaded for analysis.Measurements of anti-HCV, by chemiluminescence assay, and serum HCV RNA, by real-time quantitative RT-PCR.Data on the department of treatment, clinical and demographic features, and lifestyle risk factors were extracted.Results The most frequent clinical feature of patients treated in the Nephrology Department was hemodialysis (80.0%) , in the Obstetrics and Gynecology Department was surgery (64.7%) , and in the Infectious Diseases Department was blood transfusion (39.0%) followed closely by intravenous drug abuse (28.6%) .In the other departments (collectively pooled) , blood transfusion (40.7%) and intravenous drug abuse (37.0%) were the most frequent.The differences in rates of the most frequent clinical features from among the four groups of hospital departments were statistically significant (P<0.01) .The most frequently reported cause of infection for patients aged 40 years or younger was intravenous drug use (38.2%) , while patients over 40 were mainly infected by blood transfusion (49.3%) ;for both cuases, the differences in rates between the two age groups were statistically significant (P<0.01) .Male patients were mainly infected by intravenous drug use (35.0%) and blood transfusion (32.5%) , while female patients were mainly infected by surgery (32.7%) and blood transfusion (26.9%) ;for these four causes, the differences in rates between the two sex groups were statistically significant (P<0.01) .Conclusion The mode of HCV infection among the population stratified by age and sex shows clear diversification.Intravenous drug abuse appears to be an important infection route for younger individuals and males.
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Key words:
- hepatitis C /
- chronic
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[1]Ghany MG, Strader DB, Thomas DL, et al.Diagnosis, manage-ment, and treatment of hepatitis C:an update[J].Hepatology, 2009, 49 (4) :1335-1374. [2]魏欣, 谢玉梅, 陈琳, 等.丙型肝炎肝硬化的“分级”及聚乙二醇干扰素α-2a联合利巴韦林的抗病毒治疗[J].临床肝胆病杂志, 2011, 27 (1) :89-92. [3]Esteban JI, Sauleda S, Quer J.The changing epidemiology of hepa-titis C virus infection in Europe[J].J Hepatol, 2008, 48 (1) :148-162. [4]Zhou YQ, Wang XH, Mao Q, et al.Changes in modes of hepatitisC infection acquisition and genotypes in southwest China[J].J ClinVirol, 2009, 46 (3) :230-233. [5]张建华, 钟怀印, 薛承岩.不同人群丙型肝炎病毒传播途径分析[J].临床肝胆病杂志, 2007, 23 (4) :253-254. [6]何强, 康志敏, 王芳, 等.实施感染防治措施对血液透析乙肝及丙肝病毒感染控制的效果观察[J].实用医院临床杂志, 2010, 7 (4) :49-51. [7]胡晓武, 丁必芝.丙型肝炎流行病学及临床特征调查分析[J].实用肝脏病杂, 2010, 13 (3) :188-189. [8]Andriulli A, Mangla A, Iacobellis A, et al.Meta-analysis:theoutcome of anti-viral therapy in HCV genotype 2 and genotype 3infected patients with chronic hepatitis[J].Aliment Pharmacol T-her, 2008, 28 (4) , 397-404. [9]Sarrazin C, Schwendy S, Mller B, et al.Improved Responses toPegylated Interferon alfa-2b and Ribavirin by IndividualizingTreatment for 24-72 Weeks[J].Gastroenterology, 2011, 141 (5) :1656-1664. [10]李巧于, 郭垫, 曾菲, 等.α-1b干扰素联合利巴韦林治疗丙型肝炎临床观察[J].实用肝脏病杂志, 2010, 13 (4) :302. [11]陈文, 王鲁文, 袁念芳, 等.小剂量α-干扰素治疗失代偿期丙型肝炎肝硬化的疗效观察[J].实用肝脏病杂志, 2008, 11 (3) :174-175. [12]Nguyen-Khac E, Capron D, Castelain S, et al.Personalized ther-apy for chronic viral hepatitis C in the naive patient:How can weoptimize treatment duration as a function of viral genotype?[J].Eur J Intern Med, 2007, 18 (7) :510-515. [13]Chlabicz S, Flisiak R, Kowalczuk O, et al.Changing HCV geno-types distribution in Poland-relation to source and time of infection[J].J Clin Virol, 2008, 42 (2) :156-159.
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