出入境人员丙型肝炎传染性及危险因子研究

    张培男1,2，佟伟军1，孙洪生2，何龙英2，李令保2，吴海磊3

    1.苏州大学公共卫生学院，江苏 苏州215123；2.昆山出入境检验检疫局；3.南京出入境检验检疫局

    摘要：目的了解出入境人员丙型肝炎（HCV）感染水平，研究HCV感染者的传染性及影响感染的危险因子。方法采用酶联免疫吸附试验（ELISA）筛查出入境人员抗-HCV，并对150份抗-HCV阳性血清采用实时荧光定量PCR法测定HCVRNA病毒载量，以性别、年龄、抗-HCV阴性、HCVRNA阴性、1∶4比例为匹配条件，选择600例为阴性对照组。采用单因素和多因素非条件Logistic回归分析。结果 23781名出入境人员传染病监测体检中，检出抗-HCV阳性150例，检出率为0.63%。男女间感染HCV的几率均等；抗-HCV阳性率随年龄增长而升高，各年龄组间差异有统计学意义(χ2= 86.065，P＜0.001)；外籍人员抗-HCV阳性率显著低于中国籍，两者差异有统计学意义（χ2 =12.376，P＜0.005）；78.67%抗-HCV阳性者HCV RNA病毒处于复制状态，抗-HCV滴度≥ 1∶64感染者HCVRNA病毒载量均≥1.02 × 104 copy/ml，各抗体滴度间病毒载量有显著性差异（χ2 =136.593，P＜0.001）；经单因素回归分析发现，年龄、国籍、谷丙转氨酶（ALT）、天门冬氨酸转氨酶（AST）、直接胆红素（DBIL）、尿素（BUN）、总胆固醇（CHOL）、低密度脂蛋白（LDL）等8个因子均有统计学意义，对这8个因子进行多因素Logistic逐步回归分析，年龄、ALT、LDL等3个因子进入模型。结论78.67%出入境人员HCV感染者具有传染性，抗-HCV滴度≥1∶64指标可作为HCV具有传染性的判断指标；影响HCV感染的危险因子有年龄、国籍、ALT、AST、DBIL、BUN、CHOL、LDL等8个。

    关键词:出入境人员；丙型肝炎；传染性；危险因子

    中图分类号：R155.5　文献标识码：B

    Study on infectious and risk factors of HCVamong entry-exit personnel

    ZHANG Pei-nan*, TONG Wei-jun, SUN Hong-sheng,HE Long-yin, LI Ling-bao, WU Hai-lei

    *Suzhou University, Suzhou, Jangsu215123,China

    Abstract:   Objective  To analysis the level of hepatitis C（HCV）infection and theinfectivity and risk factors of HCV infection among entry-exitpeople.  Methods   Enzyme-linked immunosorbent assay(ELISA) screening was used for testing hepatitis C virus antibodies(anti-HCV) among entry-exit people. Real-time fluorescentquantitative PCR method was used for the determination of 150 casesof positive anti-HCV RNA in Sera of viral load. 1∶4 matchedcase-control study was conducted．The objective with same sex, age,anti-HCV negative，HCV RNA negative were recruited as matchedcontrols. Single-factor and multifactor non-conditional Logisticregression was conducted to analysis the differences between theanti-HCV positive group and negative control group.  Results   A total of 150 anti-HCV positive were foundamong 23 781 entry-exit people，with positive rate of 0.63%. Man andwomen had the equal chance of HCV infection. Anti-HCV-positive rateincreased with age (χ2 = 86.065，P＜0.001). Anti-HCV positive rate offoreign crowd was significantly lower than populations in China（χ2= 12.376，P＜0.005）. HCV RNA virus was in replication status among78.67% Anti-HCV-positive people. Viral load of HCV RNA was ≥1.02 ×104 copy/ml  among those people with anti-HCV titer ≥1∶64.Viral load of HCV RNA was significant difference among people withvarious levels of antibody titers（χ2 = 136.593，P＜0.001）.Single-factor non-conditional Logistic regression analysis showed 8risk factors including the age，nationality, ALT, AST, DBIL, BU,CHOL and LDL had significantly statistical difference. The riskfactors were taken into multifactor non-conditional Logisticstepwise regression model. In which, 3 risk factors hadsignificantly statistical difference.  Conclusion  78.67% anti-HCV positive of entry-exit people have infectious.Anti-HCV titer ≥1∶64 can be regard as the judgment index for HCVinfection. The age，nationality, ALT, AST, DBIL, BU, CHOL and LDLwere the risk factors of HCV.

    Key words:   Entry-exit people；Hepatitis C；Infectious；Risk factors

    《中国国境卫生检疫杂志》2012年6月刊