摘要
目的了解美沙酮替代治疗人群的乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)感染状况及其基因型流行情况。方法选取2013年1月-2016年1月湖南省疾控中心具有静脉吸毒史的美沙酮门诊治疗者血清,采用酶联免疫吸附法进行HBV表面抗原和抗HCV抗体的检测,采用聚合酶链反应荧光探针法检测HBV DNA和HCV RNA载量。采用HBV和HCV基因分型检测试剂盒鉴定HBV和HCV基因型。并对美沙酮门诊治疗者进行问卷调查。结果美沙酮门诊治疗组及对照组中,男性血清HBV、HCV,以及HBV合并HCV的阳性检出率与女性比较,差异无统计学意义(P>0.05)。美沙酮门诊治疗组及对照组中,多个性伴侣血清HBV、HCV及HBV合并HCV的阳性检出率高于单个性伴侣或无性伴侣,差异有统计学意义(P<0.05)。美沙酮门诊治疗组及对照组中,不同年龄组血清HBV、HCV及HBV合并HCV的阳性检出率不同(P<0.05),>45岁人群的阳性检出率最高。美沙酮门诊治疗者在不同性别、年龄及性伴侣个数的中,HBV、HCV及HBV合并HCV的阳性检出率均较对照组高,差异有统计学意义(P<0.05)。美沙酮门诊治疗组中,静脉注射吸毒者血清HBV、HCV及HBV合并HCV的阳性检出率均高于口吸毒品者,差异有统计学意义(P<0.05)。582例研究对象中,HBV成功分型104例,检测结果显示,B型72例(69.23%),C型11例(10.58%),B/C混合型13例(12.50%),非B非C型8例(7.69%)。HCV成功分型389例,检测结果显示,1a型24例(6.17%),2a型21例(5.40%),6a型184例(48.58%),1b型32例(8.22%),3a型45例(11.57%);3b型38例(9.77%),以及一定程度的混合感染。结论美沙酮门诊在治组较对照组具有高HBV、HCV及HBV合并HCV的阳性检出率;美沙酮门诊治疗人群中,HBV和HCV的易感因素为多个性伴侣、高龄及静脉注射吸毒,而性别不是HBV和HCV的易感因素。该人群中HBV感染以B型为主,HCV感染以6a型为主。
Objective To investigate the infection status and genotype epidemic condition of HBV and HCV among drug users using Methadone replacement therapy. Methods Serum samples were collected from the patients with intravenous drug use from January 2013 to January 2016, who were treated in Methadone clinics in the Centers for Disease Control and Prevention in our province. ELISA was applied to detect HBV surface antigen and anti-HCV antibody. PCR-fluorescence probe method was applied to detect HBV DNA and HCV RNA load. HCV and HBV genotyping detection kits were applied to identify genotypes of HBV and HCV. A questionnaire survey was conducted in the drug users receiving Methadone replacement therapy. Results There was no statistical difference in the positive rate of HBV, HCV or HBV combined with HCV between male and female （P 〉 0.05）. The positive rates of I-IBV, HCV and HBV combined with HCV in the drug users with multiple sexual partners were significantly higher than those in the drug users with single sexual partner or without sexual partner in both Methadone-treatment and control groups （P 〈 0.05）. In the Methadone-treatment group and the control group, the positive rates of HBV, HCV and HBV combined with HCV were significantly different in the different-age groups, the positive rate was highest in the group older than 45 years. In the study of different sex, age and numeral sexual partners, the positive rates of HBV, HCV and HBV combined with HCV in the Methadone group were significantly higher than those in the control group （P〈 0.05）. In the Methadone group, the positive rates of HBV, HCV and HBV combined with HCV in the intravenous drug users were significantly higher than those in the oral drug users （P〈 0.05）. HBV gene typing showed that among the 582 samples, there were 72 samples of genotype B （69.23%）, 11 samples of genotype C （10.58%）, 13 samples of mixed genotype B/C （12.50%） and 8 samples of neither genotype B or C （7.69%）. HCV gene typing showed that there were 24 samples of genotype la （6.17%）, 21 samples of genotype 2a （5.40%）, 184 samples of genotype 6a （48.58%）, 32 samples of genotype lb （8.22%）, 45 samples of genotype 3a （11.57%）, 38 samples of genotype 3b （9.77%） and a certain degree of mixed infection. Conclusions The positive rates of HBV, HCV and HBV combined with HCV in the drug users receiving Methadone treatment are higher than those in the control group. The muhiple sexual partners, elder age and intravenous drug injection are the risk factors of HBV and HCV infections among the drug users taking Methadone. Sex is not a predisposing factor of HBV or HCV infection. The main genotype of HBV infection is B and the main genotype of HCV infection is 6a among the drug users using Methadone replacement therapy.
出处
《中国现代医学杂志》
CAS
北大核心
2016年第21期62-67,共6页
China Journal of Modern Medicine
基金
2015年湖南省教育厅科学研究项目(No:15C0897)
关键词
美沙酮
基因型
HBV
HCV
感染
Methadone
genotype
hepatitis B virus
hepatitis C virus
infection
