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Discussion We conducted our study in rural communities of the southern Shanxi Province where illegal plasma and blood collection was common around We found a lower prevalence of HIV infection than observed in other village surveys of Chinese plasma-donating communities [ 2 — 4 , 8 ], but it is consistent with the findings of our pilot study in a random sample from 12 villages [ 21 ].
The possible explanations for the lower prevalence might include a short period of unhygienic plasma collection practices in this particular region to and the relatively late introduction of HIV into our study communities.
Overall, our study villages do not represent communities with a severe plasma donation-associated HIV epidemic as is more common in neighboring Henan Province. Our study indicated that HCV infection is the principal blood-borne viral infection of public health importance in this region given the In the communities, where injection drug use and risky sexual behavior are rare, we have little evidence from this study of ongoing HIV transmission by sexual or needle routes. Another possibility is that HIV may have been introduced into these communities later than HCV, and HCV baseline rates may have been higher at the time of the unhygienic blood donation practices.
In male subjects, residence in the village where an illegal plasma collection center had operated in around was independently associated with infections. Age above 30 years was independently associated with infections in female subjects. Due to the cross-sectional nature of this study, we cannot confirm transmission of HIV or HCV through sexual intercourse or other close interpersonal contacts and the transmission direction from husbands to wives or reverse.
HCV therapies are unaffordable for Chinese farmers with low incomes and no health insurance. Dual infection in rural residents presents an additional challenge for patient care.