Study On HBV Infection And Related Factors Among Drug Users In Compulsory Detoxification Centers

Objective:Investigate the status of Hepatitis B infection among drug users in compulsory detoxification centers in Shanxi province, Inner Mongolia Autonomous Region and Guangxi Autonomous Region.Explore the related factors of HBV infection among drug users in Shanxi province, Inner Mongolia Autonomous Region and Guangxi Autonomous Region, and provide theoretical basis for prevention and control of HBV infection among drug users.Methods:1. From June to December in 2014, 1176 drug users of 3 comp ulsory rehabilitation centers in Shanxi Province, 507 drug users of 2 compulsory rehabilitation centers in Inner Mongolia and 472 drug users of 3 compulsory rehabilitation centers in Guangxi Province,all of them were asked to answer the questionnaire and provide 5 ml blood sample. The data of the questionnaire included general demographic characteristics, the possible influence factors of HBV infection and the status of Hepatitis B vaccination etc. We use the method of ELISA to test HBs Ag and anti- HBs. The number of anti- HBs 3 10 m IU/ml was used as the standard to judge anti-HBs positive and being protective antibody. And HBs Ag positive was used as indicators of HBV infection. Then unconditional Logistic regression model was used to analyze the related factors of HBV infection, and to analysis the interaction of risk factors in the next step.2. The data was inputted by using the software Epi Data(Version 3.1). When the database is being checked and verified, the database is imported in the SPSS 20.0 software for statistical analysis. Firstly, the related influence factors of HBV infection among drug users were tested by using the chi-square test(instead of Fisher’s exact probability method when it does not meet the conditions). The related factors which were tested by the chi-square analysis and reported in the literature being statistical significance were inputted into the the unconditioned Logistic regression model in analyzing multi- factor analysis and multiplication interaction. When the P value is less than 0.05, the difference is considered to have statistical significance. Then the additive interactions between risk factors were analyzed by using Excel software edited by Andersson. The additive interaction includes three evaluation indexes: the relative excess risk due to interaction(RERI), the attributable proportion due to interaction(AP) and the synergy index(S). When the 95%CI of RERI and AP contains 0, the 95%CI of S contains 1, the additive interaction between the two factors was not considered have statistical significance.Results:1. The general situation of drug users in compulsory detoxification centersIn this study, 1176 drug users in Shanxi, 507 drug users in Inner Mongolia and 472 drug users in Guangxi completed questionnaires. A total of 1176 drug users in compulsory rehabilitation centers in Shanxi province were surveyed. The range of age was from 18 to 65 years,and the average age was(37.91 ± 8.58) years. There were 1118 male and 58 female. The Han nationality accounts for 97.79% on Ethnic distribution. The unemployed accounted for 40.61% on job distribution. Junior high school and the following cultural level accounted for 90.99% on cultural level distribution. Married people were in the majority(50.09%) marital status distribution. A total of 507 drug users in compulsory rehabilitation centers in Inner Mongolia were surveyed. The range of age was from 18 to 65 years, and the average age was(41.32±9.15) years. There were 426 male and 81 female. The Han nationality accounts for 83.63% on Ethnic distribution. The unemployed accounted for 66.67% on job distribution. Junior high sc hool and the following cultural level accounted for 80.08% on cultural level distribution. Married people were in the majority(43.98%) on marital status distribution. A total of 472 drug users in compulsory rehabilitation centers in Guangxi Province were surveyed. The range of age was from 18 to 61 years, and the average age was(36.75±8.45) years. There were 445 male and 27 female. The Han nationality accounts for 55.72% on Ethnic distribution, and Zhuang accounted for 95.69% of Ethnic minorities. The unemployed accounted for 50.64% on job distribution. Junior high school accounted for 73.73% on cultural level distribution. Unmarried people were in the majority(50.64%) on marital status distribution.From the way of taking drugs, the vast majority of drug use way in Shanxi is not injection drug use(89.97%), way of drug use in Guangxi is mainly injecting drug use, however, way of drug use in Inner Mongolia is not injection drug use(55.82%), not much higher than injection drug useHigh-risk factors related to HBV infection were of different proportion in three areas. High-risk factors in Shanxi were pedicure history(24.83%), family history of hepatitis B infection(2.55%), and a history of hepatitis C infection(11.19%), etc. High-risk factors in Inner Mongo lia were family history of hepatitis B infection(2.17%), and a history of hepatitis C infection(37.48%), etc. High- risk factors in Guangxi were high risk exposure history(62.50%), number of sexual partners in three months before held in rehab 33(36.63%), family history of hepatitis b(4.87%), etc. See table 12. HBV infection status and serum anti- HBs level of drug users in compulsory detoxification centersThe positive rate of serum HBs Ag and serum anti- HBs of three provinces from low to high in turn are Shanxi < Inner Mongolia < Guangxi. The positive rate of HBs Ag and anti-HBs in Shanxi were 4.68% and 34.69% respectively. The positive rate of HBs Ag and anti-HBs in Inner Mongolia were 7.50% and 38.86% respectively. The positive rate of HBs Ag and anti-HBs in Guangxi were 17.37% and 50.85% respectively.3. The influence factors of HBV infection of drug users in compulsory detoxification centersAccording to the analysis results in Shanxi, serum anti-HBs, family history of hepatitis B infection, pedicure history and history of hepatitis C infection are risk factors associated with HBV infection. And the OR( 95%ORCI) of each factor is 0.125(0.044~0.359)、6.654(2.550~17.364)、1.955(1.086~3.518) and 7.935(1.496~42.098) respectively. According to the analysis results in Inner Mongolia, serum anti- HBs, way of drug use and profession are risk factors are associated with HBV infection. And the OR( 95%ORCI) of each factor is 0.067(0.016~0.286) 、 2.887(1.387~6.008) and 6.839(1.392~33.596) respectively. According to the analysis results in Guangxi, the number of sexual partners in 3 months before held in compulsory detoxification centers is associated with HBV infection. And the OR( 95%ORCI) of each factor is 2.796(1.146~6.822).Conclusion:1. There are many risk factors associated with HBV infection among drug users, whose HBV infection rate is higher than the general population in the corresponding provinces respectively. The above situation suggests that drug users in compulsory detoxification centers are the high risk population. Serum anti-HBs positive is the protective factor of HBV infection. The result above highlights the necessity and importance of inoculating hepatitis b vaccination. So we should strengthen the rate of hepatitis B vaccination coverage among drug users, and improve the rate of hepatitis B vaccine coverage and serum anti- HBs positive in the crowd. And then take corresponding intervention measures to reduce HBV infection rate among drug users in compulsory detoxification centers.2. These factors including farmers, the number of sexual partners in 3 months before held in compulsory detoxification centers, history of family HBV infection, pedicure history, history of hepatitis C virus infection and injecting drugs are associated with high HBV infection rate. The above situation suggests that we should strengthen the management of drug users in compulsory detoxification centers. At the same time we should take corresponding intervention measures to control the occurrence and transmission of HBV infection. And we should strengthen the health education to make the prevention knowledge of hepatitis B infection popularization. In order to reduce the HBV infection rate in this crowd.