摘要
目的 了解维持性血液透析（MHD）患者HCV感染的危险因素及其交互作用.方法 采用多中心整群抽样方法,面对面询问,收集435例MHD患者的人口学,以及与HCV感染发生可能相关的行为因素等资料,同时检测抗-HCV和HCV RNA水平.采用非条件Logistic回归方法计算OR值和95％CI,并进行单因素和调整可能混杂因素的多因素回归分析.结果 MHD患者抗-HCV阳性30例,其中5例HCV RNA阳性,HCV感染率为6.9％.持续透析时间和HCV感染呈正相关趋势（x^2 =30.89,P＜0.01）.多因素Logistic回归分析结果显示,HBV感染、长期使用免疫抑制剂和持续透析时间≥3年是HCV感染的独立危险因素（OR值分别为2.71、4.03和5.84,P值分别为0.026、0.006和0.001）.HBV感染与透析时间≥3年,既存在相加交互作用,其超额相对危险度（RERI）、交互作用归因比（AP）和交互作用指数（S）分别为10.72、0.60和2.74,同时又存在相乘交互作用（OR=6.26,95％CI：2.25～17.44）.结论 长期使用免疫抑制剂和持续透析时间≥3年可能是HCV感染的危险因素,同时,HBV感染和透析时间≥3年间存在相加和相乘交互作用.
Objective To investigate the risk factors of hepatitis C virus （HCV） infection and their interactions among maintained hemodialysis （MHD） patients.Methods A multicenter cluster-sampled cross sectional study was conducted in Taiyuan city,Shanxi Province.Epidemiological data including demographical information and other related risk behavior of HCV infection were collected by face-to-face interviews using a self-designed questionnaire in 435 MHD patients.Meanwhile,venous blood samples of hemodialysis patients were collected for testing serum anti-HCV and HCV RNA levels.Unconditional Logistic regression was used to estimate adjusted odds ratio （OR） and 95 % confidence intervals （CI） in univariate and multivariate analyses to adjust the potential confounding factors.Results Thirty cases had positive anti-HCV,5 of which had positive serum HCV RNA.The prevalence of HCV infection in MHD patients was 6.9%.There was positive correlation between the duration of dialysis and HCV infection （x^2 =30.89,P〈 0.01）.The multivariate Logistic regression analysis showed that hepatitis B virus （HBV） infection,long-term use of immunosuppressive agents and the duration of dialysis ≥3 years were the independent risk factors for HCV infection （OR values were 2.71,4.03 and 5.84,respectively; P values were 0.026,0.006 and 0.001,correspondingly）.Data from interaction analysis showed that there were both additive interaction （the relative excess risk due to interaction （RERI）,10.72; the attributable proportion （AP） due to interaction,0.60; the synergy indexs,2.74） and multiplicative interaction （OR=6.26; 95%CI,2.25-17.44） between HBV infection and the duration of dialysis ≥3 years.Conclusions Long-term use of immunosuppressive agents and the duration of dialysis ≥3 years are probably the risk factors of HCV infection.Besides,nfection of HBV and the duration of dialysis ≥3 years have both additive and multiplicative interactions on the infection of HCV.
出处
《中华传染病杂志》
CAS
CSCD
北大核心
2014年第5期293-298,共6页
Chinese Journal of Infectious Diseases
基金
国家“十二五”艾滋病和病毒性肝炎等重大传染病防治专项--子课题3乙肝疫苗免疫策略研究资助项目（2012ZXI0002001-003）
