美沙冬門診患者感染症及肝功能狀況

Infections and Liver Function in Methadone Maintenance Patients

10.6134/tjfm.2014.0601.02

廖定烈(Ding-Lieh Liao)；陳保中(Pau-Chung Chen)

鴉片類藥物 ； 成癮 ； 美沙冬 ； 病毒性肝炎 ； 共病性 ； 慢性發炎 ； Opioid ； Addiction ； Methadone ； Viral Hepatitis ； Comorbidity ； Inflammation

台灣法醫學誌

6卷1期（2014 / 06 / 01）

17 - 22

繁體中文

背景：靜脈注射的成癮個案，有很高的比例感染有透過血液傳染的病毒。在國內，2002~2004年的HIV帶原者人數曾急速升高，其中大部分個案為靜脈注射的藥物成癮個案，促成國內開始引入美沙冬藥物治療。本研究欲透過國內接受美沙冬藥物治療的鴉片類藥物成癮者感染狀況與肝功能檢查，瞭解成癮者的感染比例、分布及肝功能異常狀況。方法：研究選取2006年9月至2008年11月於北台灣美沙冬門診個案檢驗數據，包括B型肝炎、C型肝炎、梅毒（VDRL）、愛滋病毒，以及ALT、AST、rGT等三種肝臟酵素檢測。結果：分析資料總共2,201名，其中男性1,830人，女性371人，平均年齡為38.2歲。男性個案年齡偏高，肝功能檢測也有較多的比例出現異常。B型肝炎帶原比例佔26.4％。C型肝炎感染的比例達78.2％，HIV陽性個案共239人，佔10.8％，而VDRL陽性個案佔6.0％。完全沒有HBV、HCV、HIV、及梅毒感染的，僅有11.4％。有59.4％的個案至少有其中一種感染，有25.6％個案有其中兩種感染，3.3％個案合併三種感染，而有5名個案合併了4種感染。HIV陽性的個案，平均年齡為36.7歲，ALT、AST及rGT數值均有偏高情形。結論：海洛因成癮患者處於慢性發炎狀態相當高，長期針對個案健康狀態的監測與服務，需考慮提供適切的慢性感染症治療或藥物預防。

Background: Intravenous drug users had a high rate of blood-borne virus infection. Since 2002, a rapid surge of HIV/AIDS infection with increasing proportion of intravenous drug users in Taiwan prompted the introduction of harm reduction measures including methadone maintenance therapy. Methods: This study analyzed laboratory data from one methadone clinic in northern Taiwan during 2006 and 2008. Results: In total 2,201 patients, the average age was 38.2 years old. Male patients (N=1,830) tended to have older age and higher liver enzyme data. The positive rate of HBV surface antigen, anti-HCV, anti-HIV, and VDRL were 26.4%, 78.2%, 10.8%, and 6.0%, respectively. Only 11.4% of the patients were free from all the above infections. About 59.4% of patients had positive test in the infection screening. Among the HIV-positive patients, the average age was 36.7 years old, and they tended to have higher ALT, AST, and rGT values. Conclusions: The high prevalence of chronic inflammation in heroin addiction patients justifies the routine inclusion of clinical service aiming at viral hepatitis in addition HIV infection.

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