本文關(guān)鍵詞： HIV HCV HIV-HCV合并感染 美沙酮維持治療 Meta分析　出處：《南通大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：背景：中國(guó)在2004年開(kāi)始實(shí)施美沙酮維持治療(Methadone Maintenance Treatment,MMT),最初只有8個(gè)門診,到2011年底已擴(kuò)展到738個(gè)門診。有不少研究報(bào)告了MMT門診入組人群HIV和HCV的流行情況,但不同研究的感染率差異較大。本研究的目的是通過(guò)Meta分析,綜合評(píng)價(jià)MMT入組人群HIV和HCV的流行情況,并比較不同地區(qū)的差異及時(shí)間變化趨勢(shì)。方法：設(shè)定中文關(guān)鍵詞為(“美沙酮”或“美沙酮維持治療”或“美沙酮維持”)和(“HIV”或“艾滋病”或“HCV”或“丙肝”或“合并感染”)和(“中國(guó)”或“中國(guó)大陸”),英文關(guān)鍵詞為"Methadone" OR "Methadone Maintenance Treatment" OR "Methadone Maintenance Therapy" OR "Methadone Maintenance") AND("HIV" OR "AIDS" OR "HCV" OR "hepatitis C viru" OR "co-infection") AND("China" OR "China Mainland"),搜索2004-2011年中國(guó)知網(wǎng)CNKI.維普期刊服務(wù)平臺(tái)、萬(wàn)方數(shù)據(jù)知識(shí)服務(wù)平臺(tái)和PubMed四個(gè)數(shù)據(jù)庫(kù)的文獻(xiàn)。納入的文獻(xiàn)中應(yīng)有MMT門診吸毒人群基線的HIV或HCV的感染情況,且HIV和HCV感染有實(shí)驗(yàn)室血清學(xué)診斷,文獻(xiàn)必須包含研究地點(diǎn)、研究時(shí)間和樣本量等信息。采用Comprehensive Meta-Analysis軟件,分析全國(guó)MMT入組人群HIV.HCV和HIV-HCV合并感染的總體感染率、不同地區(qū)的感染率及時(shí)間趨勢(shì)。 結(jié)果：本研究共篩選出90篇文獻(xiàn)(2篇英文和88篇中文),覆蓋全國(guó)19個(gè)省份,樣本量中位數(shù)為300,四分位數(shù)間距：175-512(樣本范圍38-8662人)。全國(guó)MMT門診中吸毒人群的HIV-HCV和HIV-HCV合并感染的流行情況分別為6.0%(95%CI:4.7%-7.7%).60.1％(95%CI:52.8%-67.0%)和4.6%(95%CI：2.9%-7.2%)。高發(fā)區(qū)的感染率明顯高于低發(fā)區(qū)(HIV:17.5%(95%CI:14.0%-21.6%) Vs2.4%(95%CI:1.6%-3.5%):HCV:70.2%(95%CI:62.6%-76.8%)Vs55.5%(95%CI:46.4%-64.2%);HlV-HCV合并感染8.0%(95%CI:4.8%-12.9%)VS2.5％(95％CI:1.4%-4.4%))。地區(qū)差異是影響HIV和HCV流行異質(zhì)性的主要原因。沒(méi)有發(fā)現(xiàn)明顯的時(shí)間趨勢(shì)(HIV:p=0.282；HCV:p=0.891；HIV-HCV合并感染：p=0.484)。 結(jié)論：中國(guó)MMT項(xiàng)目正在快速發(fā)展,納入門診的HIV陽(yáng)性者有待進(jìn)一步提高,擴(kuò)大MMT規(guī)模應(yīng)盡可能覆蓋更多的感染者,以減少艾滋病的傳播。HCV的高感染率提示在關(guān)注吸毒人群HIV防治的同時(shí),不能忽視HCV的干預(yù)。
[Abstract]:Background: methadone Maintenance treatment was introduced in China in 2004. There were only 8 outpatient clinics in China, but by end of 2011 it had been extended to 738 outpatient clinics. Many studies have reported the prevalence of HIV and HCV in MMT outpatients. The purpose of this study was to evaluate the prevalence of HIV and HCV in MMT population by Meta analysis. Methods: Chinese keywords ("methadone" or "methadone maintenance therapy" or "methadone maintenance") and ("HIV" or "AIDS" or "HCV" or "hepatitis C" or "combination") were compared. And ("Methadone" OR "Methadone Maintenance Treatment" OR "Methadone Maintenance Therapy" OR "Methadone Maintenance") and ("HIV" OR "AIDS" OR "HCV" OR "hepatitis C viru" OR "co-infection") and ("China" OR "China Mainland"), search CNKI.Weip Journal Service platform 2004-2011. Literature on the four databases of Wanfang data knowledge Service platform and PubMed. The literature included should include the baseline HIV or HCV infection of drug users in MMT outpatient clinics, and the infection of HIV and HCV should have laboratory serological diagnosis, and the literature must include the research site. Comprehensive Meta-Analysis software was used to analyze the total infection rate of HIV.HCV and HIV-HCV co-infection in MMT population in China, and the infection rate and time trend in different regions. Results: a total of 90 articles in English and 88 in Chinese were selected, covering 19 provinces in China. The prevalence of HIV-HCV and HIV-HCV co-infection among drug users in the MMT outpatient service was 6.095 CI4.7- 7.77.7cn, and 60.1% 95 CI: 52.8-67.0) and 4.695CI2.9-7.22.21.The infection rate in the high incidence area was obviously higher than that in the low incidence area, HIV17.55-95CI14.0- 21.6. Vs2.4CI2.5CI1.6- 3.50.75CIQ / 70.2CIQ / 62.62.6- 76.8Vs55.55.55.55.The infection rate in the high incidence area was obviously higher than that in the low incidence area HIV17.55-95CI14.0- 21.62.55.The infection rate was significantly higher than that in the low incidence area.) Vs2.495CI1.6-3.55.55CIQ / V70.250CIQ = 62.66-76.8Vs55.55.55.The infection rate was significantly higher than that in the low incidence area (HIV 17.55-95CI14.0-21.66.60). The main reason that influence the heterogeneity of HIV and HCV epidemic is regional difference. No obvious time trend has been found. No obvious time trend has been found in HIV: p0.891HIV-HCV co-infection. Conclusion: the MMT project in China is developing rapidly, the HIV positive patients who are included in the outpatient clinic need to be further improved, and the expansion of the MMT scale should cover as many patients as possible. In order to reduce the spread of HIV / AIDS, the high infection rate of HCV suggests that the intervention of HCV should not be ignored while paying attention to the prevention and treatment of HIV among drug users.
【學(xué)位授予單位】：南通大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R512.91;R512.63

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