2020年全国医院感染监控网丙型肝炎病毒感染监测报告

Hepatitis C virus infection: surveillance report from China Healthcare-associated Infection Surveillance System in 2020

摘要:

目的 了解医疗机构住院患者丙型肝炎病毒(HCV)感染情况及变化趋势, 为制定HCV感染防控策略提供参考依据。 方法 对2020年上报至全国医院感染监控网医院感染横断面调查资料中HCV感染监测结果进行汇总分析, HCV阳性为血清抗-HCV阳性或HCV RNA阳性, 并与2003年调查结果进行比较。 结果 2020年1 573所医院调查住院患者1 071 368例, 其中738 535例患者进行了HCV相关检测, 4 014例存在HCV感染, 检测率为68.93%, HCV阳性率为0.54%。男性患者HCV阳性率为0.60%, 女性患者为0.48%, 两者比较差异有统计学意义(χ²=47.18, P＜0.001)。年龄段以50~＜60岁组HCV阳性率最高(0.76%), 其次为40~＜50岁组, HCV阳性率为0.71%, 各年龄段比较差异有统计学意义(χ²=696.74, P＜0.001)。2003年调查住院患者91 113例, 35 145例进行HCV相关检测, 检测率为38.57%, 775例存在HCV感染, HCV阳性率为2.21%。2020年不同规模医院HCV阳性率为0.46%~0.63%, 以医院床位数600~899张者最高, 不同规模医院患者HCV阳性率比较, 差异有统计学意义(χ²=35.34, P＜0.001)。2020年有12个省/直辖市/自治区HCV相关检测患者人数＞10 000例, HCV阳性率为0.19%~0.81%, 以海南省最高; 不同科室HCV阳性率为0.06%~0.82%, 以儿科HCV阳性率最低, 内科HCV阳性率最高。2003、2020年HCV阳性率均以感染病科最高, 分别为7.95%、3.48%, 2003年其次为整形科(7.72%)、消化科(3.77%)、肾病科(3.57%)、综合重症监护病房(ICU, 3.10%), 2020年其次为消化科(1.35%)、肾病科(1.18%)、内分泌科(0.91%)、综合ICU(0.79%)。 结论 与2003年相比, 2020年HCV阳性率明显下降。HCV感染患者主要分布在感染病科, 其次为消化科、肾病科及综合ICU, HCV感染阳性率存在性别、年龄、地域的差异。

Abstract:

Objective To investigate the infection status and changing trend of hepatitis C virus (HCV) infection in hospitalized patients in medical institutions, and provide reference for formulating HCV infection prevention and control strategies. Methods HCV infection surveillance results from cross-sectional survey data reported to China Healthcare-associated Infection (HAI) Surveillance System in 2020 were summarized and analyzed, HCV positive was serum anti-HCV positive or HCV RNA positive, survey result was compared with the survey results from 2003. Results In 2020, 1 071 368 inpatients in 1 573 hospitals were surveyed, 738 535 of whom underwent HCV test, 4 014 patients were infected with HCV, with a detection rate of 68.93% and a HCV positive rate of 0.54%. The positive rate of HCV in male and female patients were 0.60% and 0.48%, respectively, with a statistically significant difference(χ²=47.18, P < 0.001). The HCV positive rate in the 50- < 60 age group was the highest (0.76%), followed by the 40- < 50 age group (0.71%). Difference among all age groups was statistically significant (χ²=696.74, P < 0.001). In 2003, 91 113 inpatients were surveyed, 35 145 of whom underwent HCV test, resulting in a detection rate of 38.57%; 775 patients were infected with HCV, with a positive rate of 2.21%. In 2020, HCV positive rates in hospitals of different scales were 0.46%-0.63%, with the highest in hospital with bed numbers ranging 600-899. Patients' HCV positive rates in hospitals of different scales was statistically significant (χ²=35.34, P < 0.001). In 2020, 12 provinces/municipalities had over 10 000 patients underwent HCV-rela-ted test, and HCV positive rates ranged 0.19%-0.81%, with the highest rate from Hainan Province. HCV positive rates in different departments were 0.06%-0.82%, with the lowest positive rate in the department of pedia-trics and the highest in the department of internal medicine. In 2003 and 2020, HCV positive rates in the department of infectious diseases were the highest, being 7.95% and 3.48%, respectively. Followed by departments of orthopedics (7.72%), gastroenterology (3.77%), nephrology (3.57%) and general intensive care unit (ICU, 3.10%) in 2003, as well as departments of gastroenterology (1.35%), nephrology (1.18%), endocrinology (0.91%), and general intensive care unit (ICU, 0.79%) in 2020. Conclusion Compared with 2003, HCV positive rate decreased significantly in 2020. HCV infected patients were mainly from the department of infectious diseases, followed by departments of gastroenterology, nephrology and general ICU. HCV infection positive rate varies with gender, age, and region.