A Study On HCV Infection And Treatment Among Rural Residents In Jianping County, Liaoning Province

ObjectiveThe death monitor result of Jianping in Liaoning Province indicated that the liver cancer mortality rate in Jianping is 1.9 times for average level of Liaoning province. The infectious disease monitor discovered that HCV incidence rate obviously is higher than other areas.The aim of the study is to determine the prevalence,influencing factors and treatment status of hepatitis C among rural residents of Jianping county,to provide the health administrative department with a scientific basis in making the effective policies to control the incidence,standardize the treatment of the hepatitis C, and reduce the financial burden for the patients.MethodStratified random cluster sampling method was used to select 1920 residnets aged 5-70 years from 24 villages of 12 towns in Jianping county.Face to face interview was conducted and 5ml vein blood samples were collected for hepatitis antibody to hepatitis C(anti-HCV) and alanine aminotransferase(ALT) detection among the subjects.HCV ribonucleic acid(HCV RNA) was detected for anti-HCV positive subjects and alpha-fetoprotein(AFP) for subjects with high risk of liver cancer.Anti-HCV was determined by enzyme-linked immunosorbent assay(ELISA) sandwich assay and the results with optical density(OD) of between one half and two times of cutoff value was ascertained by Chemiluminescence immunoassay(CIA).ALT was determined by colorimetric detection,HCV RNA by fluorescent real-time polymerase chain reaction and AFP by CIA,respective data were treated and analyzed with SPSS13.0,Monomial and multinomial logistic regression were used to identify influencing factors of HCV infection. Results1.A total of 1920 subjects were interviewed.,Eligible information of 1558 participants and 1410 blood samples were collected as the samples for the analysis which accounts for 73.43%of the total people surveyed.2.The anti-HCV positive rate among the participants was 19.50%(27.25%for male,13.51%for female).The anti-HCV positive rate increased with the growth of age.3.There were significant differences in anti-HCV positive rates among different populations.The population with history of intravenous drug users had the highest anti-HCV positive rate(92.60%) being 70 times higher than that of non-intravenous. drug users.Iatrogenic transmission was the major route for HCV infection transmission4.Factors positively correlated with increased risk of HCV infection included male,farmers,low education level,low familial income,sharing syringe for intravenous drug use.The dose-effect relationship was observed between HCV infection and age increment,numbers of risk medical procedure received,times of intravenous drug abuse and number of people sharing a syringe in an intravenous drug use.5.Only 2.2%of the subjects were diagnosed as hepatitis C by a doctor.14.04% had history of hepatitis virus detection and only 2.67%of the previous viral hepatitis examinees knew the infection status of himself or herself.The HCV infection knowledge rate was 13.81%among the subjects with positive HCV test results.The treatment rate was 12.12%and the rate of standard treatment was 8.57%among the subjects with hipatitis C.The treatment effect was poor among hipatitis C patients with un-standardized therapy.Conclusions1.The anti-HCV positive rate is 19.50%,adjusted rate is 4 times for nation rate. Jianping County is the areas of high incidence of hepatitis C.2.Factors positively correlated with increased risk of HCV infection included male,farmers,education,lliteracy,and intravenous drug users.Intravenous drug users were high-risk groups of HCV infection,Iatrogenic transmission was the major route for HCV infection transmission Jianping County.3.Jianping county has high infective rate,low detection rate of hepatitis C,low awareness,low standardized treatment.4.Jianping County is facing a big challenge of high hepatitis C infection with low diagnosis and treatment rate.It is imperative to adopt a timely and effective policy to control the incidence,standardize the treatment,and reduce its economic and social burdens.