Exposure source prevalence is associated with gender in hepatitis C virus patients from Rio de Janeiro, Brazil

BACKGROUND Hepatitis C virus (HCV) infection is a worldwide public health problem. A characterisation of the differences in exposure sources among genders will enable improvements in surveillance actions. METHODS Exposure data were obtained for 1180 confirmed HCV cases Brazil’s mandatory reporting to epidemiological surveillance, which was directed by a reference laboratory in Rio de Janeiro, Brazil. The Chi-square test (χ2) was used to assess the associations between exposure sources and gender. The prevalence ratio (PR) was calculated for exposures that showed an association. RESULTS The results showed 57.7% cases were female, and associations with snorting drugs, sexual activity, surgery, aesthetic procedures, blood transfusions, and educational level were observed (p < 0.001). Men showed 2.53 (1.33-3.57), 4.83 (3.54-6.59), and 2.18 (1.33-3.57) times more exposure to sniffing drugs, risky sex and higher levels of education, respectively, than women. Women demonstrated 4.46 (3.21-6.21), 1.94 (1.43-2.63), and 3.10 (2.09-4.61) times more exposure to surgery, aesthetic procedures, and blood transfusions, respectively, than men. CONCLUSION Our results showed differences in risk behaviours associated with gender among HCV carriers. These data are likely to significantly influence clinical practice regarding the adoption of specific approaches for counselling and control policies to prevent the emergence of new cases and break the chain of transmission of the virus.

背景 丙型肝炎病毒（Hepatitis C virus, HCV）感染是全球性公共卫生问题。明确不同性别间HCV暴露源的差异，有助于优化流行病学监测工作。
方法 本研究纳入由巴西里约热内卢一家参考实验室主导的流行病学监测体系中，通过巴西强制上报机制获取的1180例确诊HCV感染病例的暴露数据。采用卡方检验（Chi-square test, χ²）分析暴露源与性别的关联，并对存在统计学关联的暴露因素计算患病率比（Prevalence Ratio, PR）。
结果 本研究纳入的病例中57.7%为女性；分析显示，鼻吸毒品、性行为、手术、美容操作、输血及受教育水平均与性别存在显著关联（p < 0.001）。与女性相比，男性暴露于鼻吸毒品、高危性行为及高等教育水平的风险分别为女性的2.53倍（95%置信区间：1.33~3.57）、4.83倍（95%置信区间：3.54~6.59）及2.18倍（95%置信区间：1.33~3.57）。而与男性相比，女性暴露于手术、美容操作及输血的风险分别为男性的4.46倍（95%置信区间：3.21~6.21）、1.94倍（95%置信区间：1.43~2.63）及3.10倍（95%置信区间：2.09~4.61）。
结论 本研究结果表明，HCV感染者的高危行为存在性别差异。本研究数据可为临床实践提供重要参考，助力制定针对性的咨询方案与防控政策，以预防新发感染并阻断病毒传播链。