Hepatitis C in a French population-based survey, 1994: Seroprevalence, frequency of viremia, genotype distribution, and risk factors
Hepatitis C in a French population-based survey, 1994: Seroprevalence, frequency of viremia, genotype distribution, and risk factors
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DOI：
10.1002/hep.510250630
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发表时间：
1997-06-01
期刊：
影响因子：
13.5
通讯作者：
Lebas, AM
中科院分区：
文献类型：
--
作者：
Dubois, F;Desenclos, JC;Lebas, AM
这项研究的目的仅有以下几点：1)在未被选为危险因素的法国居民的人群调查中共同估计丙型肝炎病毒抗体(抗-HCV)的流行率；2)调查抗-丙型肝炎病毒血清阳性、病毒血症、感染性丙型肝炎病毒基因型和丙氨酸转氨酶(ALT)水平之间的关系；以及3)通过在该调查样本中进行嵌套病例对照研究来确定丙型肝炎病毒感染的危险因素。对6283名20岁至59岁的志愿者进行了抗-丙型肝炎病毒血清阳性率调查，这些志愿者是从45,377名在社会保障医疗中心接受常规体检的连续个体中随机挑选出来的，其中72名志愿者抗-丙型肝炎病毒阳性，未达到1.15%的患病率。经聚合酶链式反应(PCR)检测，ALT异常率为50%，HCVRNA阳性率为81%，按年龄、性别和居住地加权患病率为1.05%(95%CI：0.75~1.34)。40岁男性的加权患病率较低(0.5%；95%，CI：0.1-1.0)，在所有其他年龄和性别群体中接近1%。患病率与社会职业地位呈负相关，在无薪工作人群中的患病率最高(2.2%；95%CI：1.3-3.0)。东南部普朗斯地区丙型肝炎病毒感染率最高(1.7%；95%CI：1.0~2.3)，78%的静脉注射吸毒者感染的是1a或3型，而80%的输血相关病例感染的是1b或2a。在多因素分析中，只有3个变量与丙型肝炎病毒血清阳性率显著相关：静脉注射毒品(21例，男性14例，40岁)，既往输血(22例，女性18例)，以及无报酬工作。虽然不能正式排除静脉注射、吸毒和输血以外的传播途径，但发现这些途径在统计上并不显着。在法国，丙型肝炎似乎是一个主要的公共卫生问题。可能需要更积极的筛查政策，因为在纳入研究之前，12例患者中只有17例(24%)知道他们的丙型肝炎病毒血清阳性。
The aims of this study mere the following: 1) Co estimate the prevalence of hepatitis C virus (HCV) antibody (anti-HCV) in a population-based survey of French residents not selected for risk factors; 2) to investigate the association between anti-HCV seropositivity, viremia, the infecting HCV genotype, and the alanine transaminase (ALT) level; and 3) to identify risk factors for HCV infection by a nested case control study within this survey sample. The anti-HCV seroprevalence survey was per-formed in 6,283 volunteers (20- to 59-years-old) randomly selected from 45,377 consecutive individuals undergoing routine medical checkup in social security medical centers covering 4 of the 22 ''regions'' of France, Seventy-two volunteers were anti-HCV positive, a elude prevalence of 1.15%. Fifty percent of these positive volunteers also had an abnormal ALT level and 81% were HCV-RNA positive by polymerase chain reaction (PCR), The prevalence weighted for age, sex, and place of residence was 1.05% (95% CI: 0.75-1.34). The weighted prevalence was lower among men > 40-years-old (0.5%; 95%, CI: 0.1-1.0) and was close to 1% in all other age and sex groups. Prevalence was inversely correlated with socioprofessional status with the highest rate being found among those with no paid employment (2.2%; 95% CI: 1.3-3.0). The HCV prevalence (1.7%; 95% CI: 1.0-2.3) was highest in southeastern Prance, Seventy-eight percent of positive intervenous (IV) drug abusers were infected with HCV genotypes 1a or 3, whereas 80% of the transfusion-associated cases were infected by HCV genotypes 1b or 2a. Only three variables were significantly associated with HCV seropositivity in multivariate analysis: IV drug abuse (21 cases, 14 men all < 40-years-old), previous transfusion (22 cases, 18 women), and not having paid employment. Although routes of transmission other than IV drug abuse and transfusion may not be formally excluded they were not found to be statistically significant. Hepatitis C appears to be a major public health concern in France. A more active screening policy may be required because only 17 of 12 cases (24%) were aware of their HCV seropositivity before enrollment in the study.