Relationship Between Immune Status And Behavioral Characteristics Of Drug Addicts And Hepatitis E Infection

Objective: To investigate the relationship between high-risk behavioral characteristics,immune status and hepatitis E virus(HEV)infection,and provide a basis for HEV prevention and control.Methods: From March 2017 to March 2018,a total of 56 drug addicts in methadone clinics in Anhui Province and 112 control subjects in a physical examination center were recruited,including demographic characteristics(gender,age,occupation,income,etc.),history of previous illness,history of transfusion,drug use behaviors,sexual behaviors,and blood samples with 5 ml from each drug user and the control subject.Laboratory tests mainly include total bilirubin,alanine aminotransferase,aspartate aminotransferase,CD3,CD4,CD8,tumor necrosis factor alpha,interleukin 4,interleukin 5.Multivariate logistic regression was applied to analyze the relationship between high-risk behavioral characteristics,immune status and hepatitis E infection and the interaction effect between high-risk behavioral characteristics and immune status.Results: 1.The average age of the drug addicts in this survey was 41.2±5.9 years old,the youngest was 27 years old and the oldest was 53 years old.Among them,36 are male,accounting for 64.29% and 20 were women,accounting for 35.71%.The majority of marriage or cohabitation,accounted for 75.00%.The majority of junior high school level,accounted for 66.07%.Domicile mainly in cities,accounted for 94.64%;Smoking and drinking accounted for 89.29% and 21.43% respectively.In the control group,the average age was 38.6±13.2 years old,the youngest was 18 years old,the oldest was 77 years old.64 males subjects accounted for 57.14%,48 females subjects accounted for 42.86%;Marital status in marriage or cohabitants,accounting for 79.46%;Education in high school and above,up to 72 people,accounted for 66.07%;Domicile mainly in cities,accounted for 69.64%;Smoking,drinking accounted for 26.79% and 39.29%,respectively.The age(?2=18.227,P<0.001),household registration(?2=13.587,P<0.001),education(?2=23.638,P<0.001),smoking(?2=58.466,P<0.001),drinking(?2=5.357,P=0.021)were statistically significant between the two groups.2.The total number of HEV-IgG antibody positives among drug users was 9 cases.The positive rate was 16.07%,the antibody positive rate was no significant difference between male and female(13.89% vs 20.00%,?2=0.356,P=0.551).There was no statistical difference in marriage,education,household registration,smoking and drinking between genders(P>0.05).The total number of HEV-IgG antibodies in the control population was 19 cases,the positive rate was 16.96%,there was no significant difference between male and female groups(20.31% vs 12.50%,?2=1.189,P=0.276).There was no significant difference in marriage,educational level,household registration,smoking and drinking between genders(P>0.05).3.The positive rate of HEV-IgG was 17.31% in drug addicts with intravenous injection,and no case in drug addicts without intravenous injection,the difference was no statistical significant(P=1.000);The positive rate of HEV-IgG antibody was 16.07% in relapse subjects,and no case in drug addicts with non-relapse participants,the difference was no statistical significant(P=1.000);the HEV-IgG antibody positive rate was no significant difference in different commercial sex,blood transfusion history groups(P>0.05).The positive rate of HEV-IgG antibody in the control group was 0 and in without blood transfusion group was 17.27%,the difference was no statistical significant(?2=0.416,P=0.519).4.In drug users,there were no significant differences of CD3,CD4,CD8,TNF-?,IL-4,IL-5 between positive and negative HEV-IgG antibody groups(P>0.05).In control group,CD3 had statistically significant difference between positive and negative HEV-IgG antibody groups(t=2.09,P=0.039),while there was no significant differences of CD4,CD8,TNF-?,IL-4 and IL-5 between two goups(P>0.05).The level of TNF-? in drug addicts was siginficantly lower than that in the control group(Z=7.18,P<0.001),while there was no significant difference in the indexes of CD3,CD4,CD8,IL-4 and IL-5 between two groups(P>0.05).5.Multivariate regression analysis showed that CD3(OR=1.085,95%CI: 1.020-1.154,P=0.010)was risk factor and CD4(OR=0.925,95%CI: 0.862-0.992,P=0.028)was protective factor for the positive HEV-IgG antibody before adjustment for sex,age,while commercial sex,intravenous drug use,TNF-? were not statistically significant(P>0.05).After adjustment for sex and age,CD3(OR=1.070,95%CI: 1.005-1,140,P=0.035)was risk factor for the positive HEV-IgG antibody,while commercial sex,intravenous drug use,CD4,TNF-? were not statistically significant(P>0.05).6.The interaction effect analysis results showed that the interaction between commercial sexual behavior and CD3(P=0.906)was no statistical significance related to the positive HEV-IgG antibody.And the interaction effect between CD3 and intravenous drug use was also no statistically significant related to the positive HEV-IgG antibody(P=0.962).Conclusion: High-risk behavioral characteristics of drug users are not found to be associated with hepatitis E infection;Low levels of CD3 appear to be related to hepatitis E infection.