Increasing Newly Diagnosed Rate and Changing Risk Factors of HCV in Yanbian Prefecture, a High Endemic Area in China

BackgroundThe newly diagnosed rate of HCV infection is increasing in China. However, the risk factors have not been fully identified. Here, a survey was performed in Yanbian Prefecture, a high-endemic area in China.MethodsWe identified newly diagnosed HCV infection in 2007–2011, using the local National Disease Supervision Information Management System from the Chinese Center for Disease Control and Prevention. We determined the risk factors using a case-control survey by questionnaire.ResultsYanbian Prefecture had a rapid increase in the yearly newly diagnosed rate of HCV infection from 32.6 to 72.1/100.000 from the year 2007 to 2011. People aged 50–64 years had a high HCV infection of 43.4%, but only 0.3% of cases were reported in those aged less than 20 years. Cosmetic treatment, family history, blood transfusion, and dental treatment were independent risk factors for HCV infection. Unexpectedly, cosmetic treatments [odd ratio (OR) = 5.15, 95% confidence interval (CI) = 2.31–11.48, P = 0.00] and family history (OR = 4.68, 95% CI = 2.67–8.75, P = 0.00) showed a higher risk than the conventional risk factors of blood transfusion (OR = 4.49, 95% CI = 1.95–10.37, P = 0.001) and dental treatment (OR = 2.98, 95% CI = 1.42–6.25, P = 0.00). To further analyze the intrafamilial transmission, we found that spouses of HCV patients had an increased risk for acquiring HCV (OR = 5.75, 95% CI: 1.94–17.07), without significant association between either HCV RNA viral load (P = 0.29) or genotype (P = 0.43).ConclusionsHCV infection was increased in Yanbian Prefecture. Cosmetic treatment was a higher risk factor than medical procedure. HCV infection had a clear family clustering phenomenon, especially between spouses.

**背景** 丙型肝炎病毒（HCV）感染的新增诊断率在我国呈上升趋势，但目前其危险因素尚未完全明确。本研究在中国的高流行地区延边朝鲜族自治州开展了一项调查。

**方法** 本研究借助中国疾病预防控制中心的国家疾病监测信息管理系统本地端口，调取了2007-2011年新增诊断的HCV感染病例；同时通过问卷开展病例对照调查，以明确HCV感染的危险因素。

**结果** 2007-2011年，延边朝鲜族自治州HCV感染的年新增诊断率从32.6/10万快速升至72.1/10万。50~64岁人群的HCV感染占比达43.4%，而20岁以下人群的报告病例仅占0.3%。美容整形操作、家族史、输血及牙科治疗均为HCV感染的独立危险因素。值得注意的是，美容整形操作[比值比（Odds Ratio，OR）=5.15，95%置信区间（Confidence Interval，CI）=2.31~11.48，P=0.00]与家族史（OR=4.68，95%CI=2.67~8.75，P=0.00）的风险水平高于输血（OR=4.49，95%CI=1.95~10.37，P=0.001）与牙科治疗这类传统危险因素。为进一步分析家庭内传播情况，本研究发现HCV感染者的配偶感染HCV的风险升高（OR=5.75，95%CI=1.94~17.07），且HCV RNA病毒载量（P=0.29）与基因型（P=0.43）均与该传播无显著关联。

**结论** 延边朝鲜族自治州HCV感染率呈上升趋势；美容整形操作是比医疗操作风险更高的HCV感染危险因素；HCV感染存在明显的家庭聚集现象，尤以配偶间传播最为显著。