Van Til L D, Sweet L E
Prince Edward Island Department of Health and Social Services, Charlottetown.
CMAJ. 2000 Jan 25;162(2):199-202.
Two of the major risk factors for hepatitis C are injection drug use and receipt of blood or blood products. Many patients are unaware that they have received transfusions. In 1998 Prince Edward Island conducted a province-wide look-back notification program to notify patients who had received transfusions in PEI between Jan. 1, 1984, and June 1, 1990. The authors present the results of the notification program.
A registry for recipients of blood and blood products was created from the province's Red Cross blood bank records. The registry data were linked with Vital Statistics data to determine death status and with Health Registration data to determine residence status of recipients (in PEI or moved out of province). All identified recipients with a current PEI mailing address were sent a letter recommending hepatitis C virus (HCV) testing. Laboratory records were checked to determine HCV test results.
The registry contained data for 6086 recipients of blood or blood products during the look-back period; 51.1% (3109/6086) had died by the time of notification. Of the remainder, 18.4% (549/2977) were not directly notified because they had moved out of province, had refused delivery of the notification letter or had died recently, or because identifying information was missing from the blood bank records. Of the recipients who were notified 80.4% (1953/2428) underwent testing, and 2.2% (43/1953) were found to be HCV positive. Most of these (58.1% [25/43]) had undergone testing before notification. The HCV positivity rate differed significantly between recipients tested before notification and those tested after notification (9.9% v. 1.1%, p < 0.001). HCV-positive recipients were more likely than other notified recipients to have had multiple transfusions (39.5% v. 9.5%, p < 0.001).
Before notification 4.1% of PEI recipients had undergone HCV testing. After notification 91.2% of PEI recipients were identified as tested, dead or moved out of province. The notification program resulted in the identification of the majority of PEI's transfusion-related cases of hepatitis C.
丙型肝炎的两个主要风险因素是注射吸毒以及接受血液或血液制品。许多患者并不知道自己接受过输血。1998年，爱德华王子岛开展了一项全省范围的追溯通知计划，以通知在1984年1月1日至1990年6月1日期间在该岛接受过输血的患者。作者介绍了该通知计划的结果。
从该省红十字会血库记录中创建了一个血液和血液制品接受者登记册。登记册数据与生命统计数据相链接以确定死亡状态，并与健康登记数据相链接以确定接受者的居住状态（在爱德华王子岛或已迁出该省）。所有确定的当前在爱德华王子岛有邮寄地址的接受者都收到了一封建议进行丙型肝炎病毒（HCV）检测的信。检查实验室记录以确定HCV检测结果。
登记册包含了追溯期内6086名血液或血液制品接受者的数据；在通知时，51.1%（3109/6086）的人已经死亡。在其余的人中，18.4%（549/2977）没有被直接通知，原因是他们已迁出该省、拒绝接收通知信或最近死亡，或者血库记录中缺少识别信息。在被通知的接受者中，80.4%（1953/2428）接受了检测，2.2%（43/1953）被发现HCV呈阳性。其中大多数（58.1%[25/43]）在通知前就已经接受了检测。通知前接受检测的接受者与通知后接受检测的接受者之间的HCV阳性率有显著差异（9.9%对1.1%，p<0.001）。HCV阳性的接受者比其他被通知的接受者更有可能接受过多次输血（39.5%对9.5%，p<0.001）。
在通知前，爱德华王子岛4.1%的接受者接受过HCV检测。通知后，91.2%的爱德华王子岛接受者被确定为已接受检测、已死亡或已迁出该省。该通知计划使得爱德华王子岛大多数与输血相关的丙型肝炎病例得以被识别。
