摘要
目的 了解河南省既往报告丙型肝炎(简称丙肝)病例治疗现状及相关影响因素,为制定完善丙肝防治策略提供依据。方法 通过“中国疾病预防控制信息系统”下载并整理河南省录入日期为2004年1月1日至2021年12月31日,已终审丙肝病例报卡,选取现住址为周口市鹿邑县、南阳市镇平县和宛城区、三门峡市灵宝市的既往报告丙肝病例资料,于2022年6月至2023年9月,对存活且有联系方式的患者进行现场调查,调查内容包括研究对象的人口学特征、丙肝防治知识、既往诊疗情况等,并抽取静脉血5 mL进行丙肝病毒核酸(HCV-RNA)检测。采用χ^(2)检验比较不同特征患者HCV-RNA阳性率的差异,采用Logistic回归模型分析相关因素。结果 现场调查既往报告丙肝病例2 898例,回收有效问卷2 519份(86.92%)。2 519例研究对象中男性占46.57%(1 173例),女性占53.43%(1 346例),40岁及以上年龄组占97.06%,农民或民工占81.54%,月收入在2 000元及以下者占80.94%。丙肝知识知晓率为38.94%(981例)。调查前知道自己感染丙肝病毒的占77.41%(1 950例);既往报告确诊病例中接受过抗病毒治疗者占42.48%(765/1 801);未参加抗病毒治疗的原因主要是自觉无异常不需要治疗,占47.53%(663/1 395)。HCV-RNA阳性率为36.09%(909/2 519)。多因素Logistic回归分析显示,男性(OR=1.44,95%CI:1.13~1.82)、70岁及以上年龄组(OR=3.77,95%CI:1.79~7.24)、农民或民工(OR=1.87,95%CI:1.06~3.29)、无业或待业(OR=2.08,95%CI:1.11~3.90)、不知道自己患有丙肝者(OR=1.69,95%CI:1.26~2.26)HCV-RNA阳性概率更高。结论 河南省既往报告丙肝患者集中在40岁以上的农民或民工,需进行抗病毒治疗者占比较高,丙肝知识知晓率较低,应针对当前HCV-RNA阳性者特征及既往报告丙肝患者未治疗原因加强宣传教育,提高患者对丙肝危害的认识和对国家防治政策的了解,促进主动检测和及时规范抗病毒治疗。
Objective To understand the treatment status and influencing factors of hepatitis C(HCV)cases reported in Henan Province,and to provide evidence for the formulation of improved strategies for HCV prevention and control.Methods The final HCV reported cases of the"China Disease Prevention and Control Information System"from January 1,2004 to December 31,2021 in Henan Province were downloaded and sorted.The data of previously reported HCV cases with current addresses in Luyi County of Zhoukou City,Zhenping County and Wancheng District of Nanyang City,and Lingbao City of Sanmenxia City were selected.From June 2022 to September 2023,on-site investigations were conducted on surviving patients with contact information.The investigation included demographic characteristics,HCV prevention and treatment knowledge,and previous diagnosis and treatment.In addition,5 mL of venous blood was collected for HCV nucleic acid(HCV-RNA)detection.Chi-square test was used to compare the differences in HCV-RNA positivity rate among patients with different characteristics,and Logistic regression model was used to analyze the related factors.Results A total of 2898 reported HCV cases were investigated,and 2519 valid questionnaires were collected(86.92%).Among the 2519 subjects,46.57%were male(1173 cases),and 53.43%were female(1346 cases).The age group of 40 years and above accounted for 97.06%,farmers or migrant workers accounted for 81.54%,and those with a monthly income of 2000 yuan or below accounted for 80.94%.The awareness rate of HCV knowledge was 38.94%(981 cases).Among the respondents,77.41%(1950 cases)knew that they were infected with HCV before the investigation;and 42.48%(765/1801)had received antiviral treatment.The main reason for not receiving antiviral treatment was self-perceived absence of abnormalities and no need for treatment,which accounted for 47.53%(663/1395).The positive rate of HCV-RNA was 36.09%(909/2519).Multivariate logistic regression analysis showed that male(OR=1.44,95%CI:1.13-1.82,age group of 70 years and above(OR=3.77,95%CI:1.79-7.24),farmers/migrant workers(OR=1.87,95%CI:1.06-3.29),unemployed or jobless(OR=2.08,95%CI:1.11-3.90),and those who did not know they had HCV(OR=1.69,95%CI:1.26-2.26)had a higher probability of HCV-RNA positivity.Conclusions In Henan Province,previously reported HCV patients were mainly concentrated in farmers or migrant workers aged 40 and above,with a relatively high proportion of individuals in need of antiviral treatment and a low awareness rate of HCV knowledge.It is necessary to strengthen publicity and education targeting individuals who are positive for HCV-RNA and the reasons why previously reported HCV patients did not receive treatment,to increase patients'awareness of the harm of HCV and understanding of national prevention and control policies,and to promote proactive testing and timely standardized antiviral treatment.
作者
李宁
刘露
姬晓宇
张国龙
聂玉刚
赵东阳
LI Ning;LIU Lu;JI Xiaoyu;ZHANG Guolong;NIE Yugang;ZHAO Dongyang(Institute of Sexually Transmitted Diseases and AIDS Prevention and Treatment,Henan Provincial Center for Disease Control and Prevention,Zhengzhou 450016,Henan,China;Henan Provincial Center for Disease Control and Prevention,Zhengzhou 450016,Henan,China)
出处
《中国艾滋病性病》
CAS
CSCD
北大核心
2024年第7期683-687,共5页
Chinese Journal of Aids & STD
基金
河南省科技攻关计划项目(232102310275)
中国预防性病艾滋病基金会资助项目(2023-BGZX-08-HN)。
关键词
丙型肝炎
既往报告
流行特征
相关因素
hepatitis C(HCV)
previous reports
epidemiological characteristics
related factors
