广东省45家美沙酮维持治疗门诊接受治疗者传染病干预需求

目的 分析广东省美沙酮维持治疗(methadone maintenance treatment,MMT)门诊受治者的传染病感染现状,为门诊采取针对性的干预措施提供依据.方法 分析全省45个MMT门诊受治者的一般情况和艾滋病病毒(human immunodeficiency virus,HIV)、丙型肝炎病毒(hepatitis C virus,HCV)和肺结核(tuberculosis,TB)感染率,比较不同人群的感染率差异,分析重叠感染情况和感染者的特征.结果 13 566名受治者中,7 508人(55.3％)至少感染HIV、HCV或TB中的一种.所有受治者的HIV、HCV和TB感染率分别为5.92％、68.16％和1.87％.注射吸毒者3种疾病感染率均高于非注射吸毒者.6.0％的感染者为双重或三重感染,双重感染比例由高到低依次为HCV和HIV(4.44％)、HCV和TB( 1.31％)、HIV和TB(0.05％);54.95％的HIV感染者和57.31％的TB感染者合并HCV感染,HCV感染者以单纯感染为主(93.81％).从感染者特征来看,3种疾病感染者以男性、30～ 40岁、初中文化水平、待业/无业、注射吸毒、本地入组占多数.结论 广东省MMT门诊受治者HCV感染率高,对相关干预的需求量大;HIV和TB感染者合并HCV感染可能性大,应特别注意HCV的筛查.建议门诊积极开展针对感染者的转诊、治疗和行为干预等服务,提高项目效益.

Need for intervention on communicable diseases among outpatients in forty-five methadone maintenance treatment clinics, Guangdong Province

Objective To analyze situation of communicable diseases prevalence among outpatients with methadone maintenance treatment （MMT） in Guangdong Province and provide evidence for further intervention. Methods General characteristics and prevalence of human immunodeficiency virus （ HIV）, hepatitis C virus （HCV） and tuberculosis （TB） among MMT outpatients in 45 clinics were analyzed. Difference of prevalence among different subpopulations were compared ; types of infection and the proportion of the infected were analyzed. Results Within the 13 566 patients, 7 508 （55.3%） were infected at least one kind of communicable disease. Prevalence of HIV, HCV and TB were 5.92% , 68. 16% and 1.87%, respectively. Prevalence of three kinds of diseases among injecting drug users （IDUs） were all higher than non-IDUs. 6.0% of the infected were double or triple infected. From high to low, the proportion of double infected was HCV and HIV （4.44%）, HCV and TB （1.31%）, HIV and TB （0.05%）. 54.95% of HIV positive and 57.31% TB positive were co-infected with HCV. 93.81% HCV infected were single infected. Patients with characteristics of male, 30-40 years old, at education level of junior middle school, unemployed, injecting drugs and local registered consisted of the main part of the infected population. Conclusions Prevalence of HCV is high among outpatients with MMT in Guangdang Province. There is a potential great need for related intervention. HIV-infeetions and TB-infections have higher risk of HCV infection, so attention should be specially given to screen HCV among them. We suggest MMT clinics conduct services targeting to infected patients, such as referral, medical therapy and behavior intervention to improve benefit of MMT program.