【摘要】：目的了解社區(qū)美沙酮維持治療(MMT)門診服藥人員丙型肝炎病毒(HCV)的感染狀況,以及感染者肝纖維化的進展程度,并分析其影響因素。方法 2016年8-9月在云南和甘肅5所MMT門診,收集服藥人員的HCV感染狀況,并招募部分抗-HCV陽性者進行橫斷面研究,收集血樣,計算APRI和FIB4以評估其肝纖維化程度,并調(diào)查其人口學特征、行為習慣、治療情況以及艾滋病病毒(HIV)/HCV合并感染狀況等。結(jié)果 5所MMT門診在治人數(shù)合計2 343例,抗-HCV陽性868例(37.0%),HIV抗體陽性150例(6.4%),HIV/HCV合并感染138例(5.9%)。招募390例抗-HCV陽性服藥人員為研究對象。其中103例(占26.4%)為肝纖維化程度F2期以上,57例為F4期,占14.6%。接受HCV抗病毒治療者占13.3%(52/390)。采用HCV標準抗病毒治療者中,用干擾素或長效干擾素者26例,用干擾素或長效干擾素聯(lián)合利巴韋林的22例,用小分子藥物的4例。多因素Logistic回歸分析結(jié)果顯示,飲酒2~4次/周[比值比(OR)=2.2,95%可信區(qū)間CI:1.2~4.2]、吸毒時間≥30年(OR=7.3,95%CI:1.4~37.5)、合并HIV感染(OR=0.4,95%CI:0.2~0.7)是肝纖維化進展的影響因素。結(jié)論 MMT門診服藥人員HCV感染率較高,實際接受HCV標準抗病毒治療的比例偏低。飲酒、吸毒時間、合并HIV感染對肝纖維化的進展程度有重要的影響,應加強門診工作人員的能力建設(shè),使之能更好地對HCV感染者提供宣傳教育、咨詢及治療服務。
[Abstract]:Objective to investigate the status of hepatitis C virus (HCV) infection and the progression of hepatic fibrosis in community methadone maintenance therapy (MMT) outpatients, and to analyze the influencing factors. Methods from August to September 2016, five MMT outpatient clinics in Yunnan and Gansu were selected to collect HCV infection status of drug users, and some anti-HCV positive patients were recruited for cross-sectional study, blood samples were collected, and APRI and FIB4 were calculated to evaluate the degree of hepatic fibrosis. The demographic characteristics, behavioral habits, treatment and HIV / HCV co-infection were investigated. Results there were 2 343 cases in 5 MMT outpatient clinics, 868 cases (37. 0%) were positive for anti-HCV (6. 4%), 138 cases (5. 9%) were complicated with HIV/HCV infection. A total of 390 anti-HCV positive drug users were recruited. Among them, 103 cases (26.4%) had liver fibrosis above F2 stage, 57 cases were F4 stage, accounting for 14.6%. 13. 3% (52 / 390) received HCV antiviral therapy. 26 cases were treated with interferon or long-acting interferon, 22 cases were treated with interferon or long-acting interferon combined with ribavirin, and 4 cases were treated with small molecule drugs. The results of multivariate Logistic regression analysis showed that drinking 2 times / week [ratio of (OR) = 2.2% 95% confidence interval CI:1.2~4.2], drug use time 鈮，

本文編號：2287399