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目的了解新疆维吾尔自治区伊宁市美沙酮维持治疗者HCV感染现状、卫生服务利用情况并分析其影响因素。方法对伊宁市美沙酮维持治疗门诊18岁以上且抗-HCV阳性的在治者进行调查,内容包括人口学信息、丙肝认知、卫生服务利用情况。采集血样进行HCV-RNA、HIV-RNA定量检测和乙肝两对半检测;采用横断面调查和Logistic回归方法进行分析。结果共招募360例美沙酮维持治疗者,96.11%为男性;维吾尔族占87.50%;文化程度初中及以下者占82.22%;HCV-RNA阳性率87.22%,平均HCV-RNA(log10)为(5.30±2.23)IU/mL,HCV-RNA拷贝数≥10~5者占89.49%;HCV与HIV合并感染率为71.11%。26例因HCV感染到医院就诊,就诊率为7.22%,14例在就诊时接受了HCV-RNA检测;5例曾接受干扰素治疗。文化程度高中及以上(AOR=3.25,95%CI:1.24~8.55)、曾有HCV症状体征(AOR=6.67,95%CI:2.57~17.35)和丙肝知识认知良好(AOR=2.70,95%CI:1.12~6.53)是促进美沙酮门诊HCV感染服药人员就诊的因素。结论伊宁市美沙酮门诊感染HCV服药人员HCV病毒复制水平高,因HCV到医院就诊率低,需在美沙酮门诊加强丙肝相关咨询和宣教,促进HCV感染者及时寻求医疗卫生服务,减少疾病负担。
Objective To understand the status quo of HCV infection and utilization of health services in methadone maintenance treatment in Yining City, Xinjiang Uygur Autonomous Region and to analyze its influencing factors. Methods A total of 18 persons over the age of methadone maintenance treatment clinics in Yining City were investigated for anti-HCV positive, including demographic information, cognition of hepatitis C and utilization of health services. Blood samples were collected for HCV-RNA, HIV-RNA quantitative detection and hepatitis B two pairs of semi-test; using cross-sectional survey and Logistic regression analysis. Results A total of 360 cases of methadone maintenance were recruited, 96.11% were male, Uyghur accounted for 87.50%, 82.22% were junior high school education and below, HCV-RNA positive rate was 87.22% and average HCV-RNA log10 was 5.30 ± 2.23) IU / mL, HCV-RNA copy number ≥10 ~ 5 accounted for 89.49%; HCV and HIV co-infection rate was 71.11%. Twenty-six patients were hospitalized for HCV infection, with a referral rate of 7.22%; 14 patients were tested for HCV-RNA at the time of their visit; and 5 patients had received interferon. (AOR = 6.67, 95% CI: 2.57-17.35) and HCV knowledge (AOR = 3.70, 95% CI: 1.24-8.55) CI: 1.12 ~ 6.53) is to promote methadone clinics HCV infection medication staff treatment factors. Conclusion HCV replication in HCV drug abusers in methadone outpatient clinics in Yining City is high. Because of low HCV to hospital attendance, hepatitis C-related counseling and education should be stepped up in methadone clinics so as to promptly seek medical and health care services and reduce the burden of diseases.