云南省德宏州2016-2017年新报告中国和缅甸籍HIV感染者中HCV的流行病学特征
doi: 10.16462/j.cnki.zhjbkz.2019.10.026
Epidemiological characteristics of co-infection of hepatitis C virus among newly reported HIV infeced patients in Chinese and Burmese from 2016 to 2017 in Dehong Prefecture of Yunnan Province
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摘要:
目的 了解德宏州新报告人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者中丙型肝炎病毒(hepatitis C virus,HCV)阳性率及其流行病学特征。 方法 采用横断面调查方法,对2016-2017年云南省德宏州新报告的2 196例HIV感染者进行HCV抗体检测。 结果 在HIV感染患者中共检测出HCV阳性694例,阳性率为31.6%。其中,中国与缅甸籍新报告HIV感染者中HCV阳性率分别为14.4%(112/780)、41.1%(582/1 416)。不同国籍中HIV/HCV阳性率均以男性、少数民族如傣族和景颇族、小学及以下文化程度和农民较高。多因素Logistic回归分析模型分析结果显示,在中国籍和缅甸籍感染者中,HIV/HCV合并感染与男性、傣族、经注射吸毒感染HIV及农民均有关联。 结论 云南省德宏州新报告的HIV感染者中有较高的HCV阳性率,中国和缅甸籍HIV/HCV合并感染的流行病学特征各有不同,应对不同国籍的感染者需要采取不同的防控措施。 Abstract:Objective To understand the prevalence and epidemiological characteristics of hepatitis C virus (HCV) co-infection among newly reported HIV-infected patients from 2016 to 2017 in Dehong Prefecture of Yunnan Province. Methods A cross-sectional survey was conducted to detect HCV antibodies in 2 196 newly reported HIV-infected persons in Dehong Prefecture, Yunnan Province, from 2016 to 2017. Results A total of 694 cases(31.6%) were detected antibodies against HCV during HIV-infected persents. The prevalence of HCV co-infection among newly reported HIV-infected patients in Chinese and Burmese was 14.4% (112/780) and 41.1% (582/1 416), respectively. Moreover, the prevalence of HCV co-infection was higher in male, ethnic minorities such as Dai and Jingpo minority, primary school and below and farmers in both Chinese and Burmese. Multivariate Logistic regression model showed that HCV infection was associated with male, Dai minority, HIV infection by injecting drug and famers among Chinese and Burmese reported HIV-infected patients. Conclusions The prevalence of HCV co-infection was high among newly reported in Dehong Prefecture of Yunnan Province. Meanwhile, the epidemiological characteristics of HIV/HCV co-infections in Chinese and Burmese are different, thus different prevention and control measures are needed for patients of different nationalities. -
Key words:
- HIV /
- HCV /
- Co-infection /
- Chinese /
- Burmese /
- Popular feature
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表 1 云南省德宏州2016-2017年新报告中国和缅甸籍HIV感染者及合并HCV感染者流行病学特征
Table 1. Epidemiological characteristics of co-infection of HCV among newly reported HIV infections in Chinese and Burmese from 2016 to 2017 in Dehong Prefecture of Yunnan province
变量 中国 合计
(n=780)χ2值 P值 缅甸 合计
(n=1 416)χ2值 P值 HCV阴性
(n=668)HCV阳性
(n=112)HCV阴性
(n=834)HCV阳性
(n=582)年龄(岁) 2.05 0.563 41.27 < 0.001 <18 19(2.8) 1(0.9) 20(2.6) 7(0.8) 2(0.3) 9(0.6) 18~ 163(24.4) 29(25.9) 192(24.6) 329(39.4) 294(50.6) 623(44.0) 30~ 181(27.1) 34(30.4) 215(27.6) 271(32.5) 206(35.5) 477(33.7) ≥40 305(45.7) 48(42.9) 353(45.3) 227(27.2) 79(13.6) 306(21.6) 性别 32.24 < 0.001 263.58 < 0.001 男 420(62.9) 101(90.2) 521(66.8) 429(51.4) 537(92.3) 966(84.3) 女 248(37.1) 11(9.8) 259(33.2) 405(48.6) 45(7.7) 450(39.3) 民族 35.28 < 0.001 117.55 < 0.001 汉族 335(50.1) 24(21.4) 359(46.0) 111(13.3) 76(13.1) 187(16.3) 傣族 174(26.0) 38(33.9) 212(27.2) 460(55.2) 164(28.2) 624(54.5) 景颇族 112(16.8) 37(33.0) 149(19.1) 196(23.5) 269(46.2) 465(40.6) 其他 47(7.0) 13(11.6) 60(7.7) 67(8.0) 73(12.5) 140(12.2) 文化程度 20.77 < 0.001 27.07 < 0.001 小学及以下 334(50.0) 82(73.2) 416(53.3) 570(68.3) 470(80.8) 1 040(90.8) 中学及以上 334(50.0) 30(26.8) 364(46.7) 264(31.7) 112(19.2) 376(32.8) 婚姻状况 1.17 0.556 54.32 < 0.001 未婚 171(25.6) 30(26.8) 201(25.8) 245(29.4) 283(48.6) 528(46.1) 已婚有配偶 350(52.4) 53(47.3) 403(51.7) 505(60.6) 256(44.0) 761(66.4) 离婚或丧偶 147(22.0) 29(25.9) 176(22.6) 84(10.1) 43(7.4) 127(11.1) 传播途径 210.58 < 0.001 359.85 < 0.001 异性传播 607(90.9) 62(55.4) 669(85.8) 759(91.0) 274(47.1) 1 033(90.1) 同性传播 31(4.6) 0(0.0) 31(4.0) 4(0.5) 0(0.0) 4(0.3) 注射吸毒 19(2.8) 50(44.6) 69(8.8) 66(7.9) 308(52.9) 374(32.6) 母婴传播 11(1.6) 0(0.0) 11(1.4) 5(0.6) 0(0.0) 5(0.4) 职业 15.93 < 0.001 108.03 < 0.001 农民 477(71.4) 100(89.3) 577(74.0) 480(57.6) 487(83.7) 967(68.3) 非农民 191(28.6) 12(10.7) 203(26.0) 354(42.4) 95(16.3) 449(31.7) CD4+T淋巴细胞(cell/μL) 5.99 0.112 25.88 < 0.001 < 200 156(23.4) 26(23.2) 182(23.3) 104(12.5) 58(10.0) 162(14.1) 200~ 134(20.1) 33(29.5) 167(21.4) 112(13.4) 112(19.2) 224(19.5) 350~ 131(19.6) 21(18.8) 152(19.5) 111(13.3) 160(27.5) 271(23.6) ≥500 181(27.1) 22(19.6) 203(26.0) 195(23.4) 151(25.9) 346(30.2) 表 2 云南省德宏州2016-2017年新报告中国和缅甸籍HIV感染者中HCV阳性率的多因素Logistic回归分析
Table 2. Multivariate Logistic regression analysis of co-infection of HCV among newly reported HIV-infected patients in Chinese and Burmese from 2016 to 2017 in Dehong Prefecture of Yunnan Province
中国籍 缅甸籍 HCV阳性率 OR(95% CI) P值 HCV阳性率 OR(95% CI) P值 年龄(岁) <18 5.0 22.2 1.00 18~ 15.1 47.2 4.09(0.16~11.37) 0.393 30~ 15.8 43.2 2.29(1.39~3.76) 0.001 ≥40 13.6 25.8 2.46(1.53~3.97) < 0.001 性别 男 19.4 1.00 55.6 1.00 女 4.2 0.23(0.12~0.46) < 0.001 10.0 0.10(0.06~0.16) < 0.001 民族 汉族 6.7 1.00 40.6 1.00 傣族 17.9 2.40(1.28~4.50) 0.006 26.3 0.54(0.32~0.92) 0.020 景颇族 24.8 3.29(1.69~6.40) < 0.001 57.8 1.34(0.78~2.29) 0.288 其他 21.7 3.41(1.38~8.38) 0.008 52.1 1.31(0.65~2.66) 0.453 文化程度 小学及以下 19.7 1.00 45.2 1.00 中学及以上 8.2 0.72(0.42~1.23) 0.223 29.8 0.65(0.44~0.98) 0.039 婚姻状况 未婚 14.9 53.6 1.00 已婚有配偶 13.2 33.6 0.82(0.42~1.59) 0.554 离婚或丧偶 16.5 33.9 0.55(0.30~1.00) 0.052 传播途径 异性传播 9.3 1.00 26.5 1.00 同性传播 0.0 0(0.00~0.00) 0.998 0.0 0(0.00~0.00) 0.999 注射吸毒 72.5 12.96(6.91~24.30) < 0.001 82.4 5.11(3.46~7.56) < 0.001 母婴传播 0.0 0(0.00~0.00) 0.999 0.0 0(0.00~0.00) 0.999 职业 农民 17.3 1.00 50.4 1.00 非农民 5.9 0.71(0.34~1.47) 0.354 21.2 0.54(0.36~0.86) 0.008 CD4+T淋巴细胞(cell/μL) < 200 14.3 35.8 1.00 200~ 19.8 50.0 1.51(0.87~2.63) 0.148 350~ 13.8 59.0 2.09(1.23~3.56) 0.007 ≥500 10.8 43.6 1.44(0.87~2.40) 0.159 注:将表 1中P < 0.10的变量纳入多因素回归分析。 -
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