[Prevalence of risk factors and mechanisms of transmission of acute viral hepatitis type B and C in Bucharest municipality: 2001-2008].

Niculae Ion-Nedelcu, Corina Iordăchescu, Patricia Gherasim, Rodica Mihailovici, Cornelia Dragomirescu, Ruxanda Dumitrache-Marian, Cristina Moculescu
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Abstract

Objective: Analysis of risk factors for achieving clinically overt hepatitis B and hepatitis C in the population of Bucharest municipality.

Methods: retrospective and descriptive study on hospital patients cohort. Cases - in the study have been enrolled all acute viral hepatitis B and C confirmed by the two infectious diseases university clinics of Bucharest municipality, during the time interval 2001-2008, among the residents of the municipality. Infection risk factors - for every case of hepatitis B and hepatitis C with the simptoms onset placed during the time interval 2001-2008, it was associated "the most plausible" risk factor, detected by case investigation. For contemplation of control strategies the risk factors were stratified by mechanisms of virus transmission and by age groups. The analysis consists mainly in statistical comparing of cases prevalence in each etiology by risk factors and mechanisms of visus transmission.

Results: Patients cohort included 1440 hepatitis B cases and 227 hepatitis C cases, respectively. The most prevalent individual risk factor in hepatitis B was the sexual contact with multiple partners (51,0%) while in hepatitis C the use of ilegal injectable drugs (46,3%). The prevalences of hepatitis B and hepatitis C cases by the four mechanisms of virus transmmission were similar (p = 0,52). For both etiologies the high risk behaviours represented the principal mechanism of virus transmission (64,1% in hepatitis B and 63,4% in hepatitis C, respectively); additionaly, for both etiologies the most prevalent mechanisms of virus transmission by age groups were indentically, namely: (a) consumption of medical services in the age group 55+ years, (b) high risk behaviours in the age group 13-54 years and (c) contact with case or virus carrier in the age group 0-12 years, respectively.

Conclusions: in the time period 2001 - 2008 the structure by mechanisms of virus transmission in hepatitis B and hepatitis C cases reported in the population of Bucharest municipaly was statistically similar, for both etiologies the most prevalent mechanism (> 60%) was represented by high risk behaviours. This reality strongly suggests that additionaly to the current strategies for prevention of the infection with hepatitic visuses B and C, the decisive strategy to control of the two infection needs to be extended with an effective education satelite focused on high risk groups.

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[布加勒斯特市急性乙型和丙型病毒性肝炎的危险因素和传播机制:2001-2008]。
目的:分析布加勒斯特市人群临床显性乙型肝炎和丙型肝炎的危险因素。方法:对住院患者进行回顾性和描述性研究。本研究纳入了2001-2008年期间布加勒斯特市两所传染病大学诊所在该市居民中确诊的所有急性病毒性乙型肝炎和丙型肝炎病例。感染风险因素——对于2001-2008年期间出现症状的每一例乙型和丙型肝炎病例,通过病例调查发现,这是“最合理的”风险因素。为了考虑控制策略,危险因素按病毒传播机制和年龄组分层。分析主要包括按危险因素和病毒传播机制对各种病因的病例流行率进行统计比较。结果:本组患者中乙型肝炎1440例,丙型肝炎227例。乙型肝炎中最普遍的个人危险因素是与多个性伴侣发生性接触(51.0%),而丙型肝炎中最普遍的个人危险因素是使用非法注射药物(46.3%)。乙型肝炎和丙型肝炎病例通过四种病毒传播机制的患病率相似(p = 0,52)。对于这两种病因,高危行为是病毒传播的主要机制(在乙型肝炎和丙型肝炎中分别为64.1%和63.4%);此外,就这两种病因而言,各年龄组最普遍的病毒传播机制是相同的,即:(a) 55岁以上年龄组的医疗服务消费,(b) 13-54岁年龄组的高风险行为,以及(c) 0-12岁年龄组与病例或病毒携带者接触。结论:在2001 - 2008年期间,布加勒斯特市人口中报告的乙型肝炎和丙型肝炎病例的病毒传播机制结构在统计上是相似的,对于这两种病因,最普遍的机制(> 60%)是由高风险行为代表的。这一现实强烈表明,除了目前预防乙型和丙型肝炎病毒感染的战略外,需要扩大控制这两种感染的决定性战略,并对高危人群进行有效的教育。
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