某療養院海洛因依賴住院病患C型肝炎盛行率及其相關因素研究

The Prevalence and Its Related Factors of Hepatitis C for Heroin Dependence Inpatients in a Psychiatric Center

林滄耀(Tsang-Yaw Lin) ； 李世凱(Shi-Kai Lee) ； 陳瑾樺(Chin-Hua Chen) ； 吳聖良(Shang-Liang Wu)

《醫保研究雜誌》 1卷1期 (2005/03) Pp. 21-30

https://doi.org/10.29827/YBYJZZ.200503.0003

摘要

目的：瞭解海洛因依賴病人C型肝炎病毒抗體陽性盛行率及其感染之相關因素。方法：樣本爲住院解毒治療病人，合乎DSM-IV海洛因依賴診斷標準共419人，資料蒐集工具爲結構式問卷。結果：注射方式使用海洛因者佔84.7%，其中有71.5曾經共用針頭／空針，且其C型肝炎病毒抗體陽性率爲77.4%；共用注射針頭次數與C型肝炎病毒抗體陽性有顯著相關，即每多一次共用注射針頭／空針就增加1.15倍感染C型肝炎病毒的機會。結論與建議：(1)於藥癮治療之醫療院所門診及急診提供免費C型肝炎病毒檢驗。(2)針對C型肝炎病毒抗體及愛滋病毒抗體陽性病人，建立轉介至內科治療之流程，並將患者列入個案管理方案內，以利後續追蹤並提高後續治療完成率。(3)考慮小規模實驗性的設立針頭／空針交換方案，在特定地點提供免費之乾淨注射工具，以評估對共用注射針頭／空針發生率及對C型肝炎病毒及愛滋病毒傳染之影響。

關鍵字

海洛因依賴 ； C型肝炎病毒 ； 危險因素

並列摘要

Purpose: To investigate the prevalence of hepatitis C antibody among heroin dependence patients and the risk factors for hepatitis C virus (HCV) infection. Methods The study subjects were recruited from the patient population who were admitted for the heroin detoxification. 419 patients diagnosed to be heroin dependence were included in the study. Results: 84.7% of the heroin dependence patients were intravenous drug users of which 71.5% shared needles/syringes (N/S), and 77.4% showed HCV Ab seropositive. From the OR, It was found that the HCV infection rate increased 1.15 times for each additional N/S sharing. Recommendations: (1) Provide free HCV testes to the patients who came to the Psychiatric institutions for substance abuse treatment. (2) Set up a treatment process of referring HCV and HIV seropositive patients to the Internal Medicine Deportment for further intervention. The case management system should be established so that the completion rate of the treatment will be increased. (3) Consider a pilot free N/S exchange program with afford aseptic N/S to substance abuser in order to investigate its benefit.

並列關鍵字

heroin dependence ； hepatitis C virus ； risk factors