2013-2015年长途卡车司机丙型肝炎病毒感染状况及其影响因素

目的了解长途卡车司机丙型肝炎病毒(HCV)感染状况及其影响因素,为丙肝综合防治和科学干预提供信息和依据。方法 2013-2015年,每年4-6月份在广西浦寨边境贸易城的停车场采用"滚雪球、同伴推动"等方法招募400名调查对象,调查其一般人口学特征、行为特征等相关资料信息,并采集3~5 ml静脉血进行HIV、梅毒、HCV抗体检测,分析其中HCV感染状况及探讨影响长途卡车司机人群感染HCV的可能因素。结果 2013-2015年,共调查1 200名长途卡车司机中,检出HCV抗体阳性9例,HCV总的感染率为0.75%,HCV感染率各年差异无统计学意义(χ~2=1.760,P=0.528)。有注射吸毒行为史、梅毒抗体阳性的HCV感染率分别为33.33%和5.41%,远高于无注射吸毒行为(0.67%)和梅毒抗体阴性(0.60%)者,差异均有统计学意义(χ~2=42.895,P=0.022;χ~2=11.115,P=0.029);不同年龄、不同婚姻状况、不同户籍所在地、不同民族、不同文化程度、有无嫖娼行为、嫖娼时是否使用安全套对HCV感染率影响差异无统计学意义(χ~2=0.369~2.527,均P>0.05)。多因素logistic回归分析显示,注射吸毒(OR=40.915,95%CI:2.518~664.836)、梅毒抗体阳性(OR=6.951,95%CI:1.194~40.468)是长途卡车司机感染HCV的主要危险因素。结论 2013-2015年广西边境地区长途卡车司机的HCV感染率较高,HCV感染与长途卡车司机的注射吸毒行为、梅毒感染传播有关,应当继续加强长途卡车司机人群的宣传教育和行为干预,促进高危行为的改变,以有效控制HCV的感染和传播。

Status of hepatitis C virus infection and its influencing factors among long-distance truck drivers, 2013-2015

Objective To investigate the status of hepatitis C virus (HCV) infection and its influencing factors among long-distance truck drivers so as to provide information and evidence for comprehensive prevention and treatment and scientific intervention of hepatitis C. Methods During the period of 2013-2015, snowball sampling and respondent driven sampling were used to recruit 400 surveyed subjects in the parking lot in Guangxi Puzhai border trade city from April to June in each year, their general demographic characteristics, behavior characteristics and other related information were investigated. 3-5 ml venous blood samples were collected to detect antibodies against HIV, syphilis and HCV. The status of HCV infection and its possible influencing factors among long-distance truck drivers were analyzed. Results A total of 1,200 long-distance truck drivers were investigated during 2013-2015. 9 cases were positive for anti-HCV antibody, and the total infection rate of HCV was 0.75%. No statistically significant difference was found in the infection rate of HCV among the three years (χ²=1.76, P=0.528). The infection rates of HCV in the drivers with history of drug injection behavior and with syphilis antibody-positive serum were significantly higher than those in the drivers without history of drug injection behavior and with syphilis antibody-negative serum (33.33% vs. 0.67%, 5.41% vs. 0.60%), showing statistically significant differences (χ²=42.895, P=0.022; χ²=11.115, P=0.029).Age, marital status, registered permanent residence, nationalities, educational backgrounds, whether or not whoring andwhether or not using condoms during actsof prostitution didn’t have significant effectson the infection rate of HCV (χ²=0.369-2.527, all P>0.05). Multivariate logistic regression analysis showed that injection drug use (OR=40.915, 95%CI:2.518-664.836) and syphilis antibody-positive (OR=6.951, 95%CI: 1.194-40.468) were the main risk factors for HCV infection in the drivers. Conclusions The infection rate of HCV in the long-distance truck drivers in Guangxi border areas is high. HCV infection is related to the long-distance truck drivers’ injection drug use and syphilis infection spread. It is necessary to continuously strengthen the publicity, education and behavioral intervention among the long-distance truck drivers and promote the changes of high-risk behavior so as to effectively control the infection and spread of HCV.