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目的探讨社区美沙酮维持治疗(methadone maintenance treatment,MMT)新入组者丙型肝炎病毒(hepatitis C virus,HCV)感染率的变化趋势及相关危险因素。方法以2006-2014年广东省8 830名MMT新入组者为研究对象,计算不同年份HCV感染率,采用Logistic回归分析相关危险因素。结果 2006-2008年、2009-2011年、2012-2014年分别新入组4 485人、3 028人、1 317人,HCV感染率分别为77.1%、80.7%、77.0%,趋势性x~2检验差异无统计学意义(X_(趋势)~2=1.72,P=0.189)。多因素分析结果显示:2006-2008年较高的文化程度、已婚有配偶是HCV感染的保护因素(均有P<0.05);吸毒年限长、过去半年与毒友交往次数多、有注射吸毒史是HCV感染的危险因素(均有P<0.05)。2009-2011年较高的文化程度、已婚有配偶是HCV感染的保护因素(均有P<0.05);吸毒年限长、过去半年与毒友交往次数多、有注射吸毒史是HCV感染的危险因素(均有P<0.05)。2012-2014年女性、吸毒年限长、有注射吸毒史是HCV感染的危险因素(均有P<0.05)。结论 MMT新入组者HCV感染率较高且无下降趋势;危险因素有所变化,但吸毒年限长和注射吸毒是HCV感染的持续性高危因素。应进一步加强MMT门诊宣传及HCV防控工作。
Objective To investigate the change trend and related risk factors of infection rate of hepatitis C virus (HCV) in new community methadone maintenance treatment (MMT). Methods A total of 8 830 newly admitted MMT patients in Guangdong Province from 2006 to 2014 were enrolled in this study. HCV infection rates in different years were calculated. Logistic regression analysis was used to analyze the relevant risk factors. Results The number of newly infected patients was 4 485, 3 028 and 1 317 respectively from 2006 to 2008, from 2009 to 2011 and from 2012 to 2014. The HCV infection rates were 77.1%, 80.7% and 77.0%, respectively. The trend of x ~ 2 test The difference was not statistically significant (X_ (trend) ~ 2 = 1.72, P = 0.189). The results of multivariate analysis showed that the higher educational attainment of 2006-2008, the married spouse were the protective factors of HCV infection (both P <0.05), the longer drug-taking period, the more contacts with poisonous friends in the past six months, the injection drug abuse History is a risk factor for HCV infection (both P <0.05). 2009-2011 Higher educational level, married spouse is a protective factor of HCV infection (all P <0.05); long drug life, more contact with poisonous friends in the past six months, the history of injecting drug use is the risk of HCV infection Factors (all P <0.05). Women from 2012 to 2014, with a long history of drug abuse and a history of injecting drug use, were risk factors for HCV infection (both P <0.05). CONCLUSIONS: The HCV infection rate in newly recruited patients with MMT is high and there is no downward trend. The risk factors have changed. However, the long duration of drug abuse and injecting drug use are the persistent high risk factors for HCV infection. MMT outreach and HCV prevention and control should be further strengthened.