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目的了解美沙酮替代治疗者丙肝、乙肝、艾滋病及梅毒感染情况及高危因素,为制定防控措施提供依据。方法对接受美沙酮替代治疗的1 149例进行问卷调查;采集静脉血标本,用ELISA法检测抗-HCV、HBV标志物、抗-HIV和梅毒抗体。结果 1 149例中男性检出抗-HCV 569例(49.5%),HBsAg阳性25例(2.2%),抗HIV阳性31例(2.7%),梅毒抗体阳性5例(0.4%)。抗-HCV阳性者中,女性感染率(63.4%)高于男性(46.8%),感染率最高为30~49岁组。注射吸毒为HCV感染的高危因素。93例HCV感染者中,HCV RNA大于2.7log10拷贝/mL有61例(65.6%)。61例HCV RNA阳性标本中,基因型以1b型为主(65.7%)。结论美沙酮替代治疗的吸毒人群中,抗-HCV阳性率远超自然人群,尤以注射吸毒者感染率为高;其HCV基因型与福建自然人群感染丙肝基因型一致;65.6%HCV感染者存在HCV RNA高复制,需要进行抗病毒治疗。
Objective To understand the infection status and risk factors of hepatitis C, hepatitis B, AIDS and syphilis in methadone replacement therapy and provide evidence for prevention and control measures. Methods A total of 1 149 cases receiving methadone replacement therapy were surveyed. Venous blood samples were collected for anti-HCV, HBV markers, anti-HIV and syphilis antibodies by ELISA. Results Of the 149 cases, 569 (49.5%) were anti-HCV, 25 (2.2%) were HBsAg positive, 31 (2.7%) were anti-HIV positive and 5 (0.4%) were positive for syphilis. Among the anti-HCV positives, the prevalence of females (63.4%) was higher than that of males (46.8%), and the highest infection rate was between 30-49 years old. Injecting drug use is a risk factor for HCV infection. Of the 93 HCV-infected individuals, 61 (65.6%) had HCV RNA greater than 2.7 log10 copies / mL. Among the 61 HCV RNA positive samples, the genotype was predominantly 1b (65.7%). Conclusions The positive rate of anti-HCV in drug addicts treated with methadone is much higher than that in natural persons, especially in injecting drug users. HCV genotype is consistent with hepatitis C virus genotype in natural population of Fujian. HCV RNA is present in 65.6% of HCV infected persons High replication requires antiviral therapy.