Sypsa V, Hadjipaschali E, Hatzakis A
Department of Hygiene and Epidemiology, Athens University Medical School, Greece.
Eur J Epidemiol. 2001;17(8):721-8. doi: 10.1023/a:1015671627577.
A cross-sectional study was carried out in employees of 17 Greek companies with the aim of assessing the prevalence of hepatitis B (HBV) and hepatitis C (HCV) virus, identifying associated prognostic/risk factors and evaluating the effectiveness of a questionnaire as a pre-screening tool. All participants were asked to complete a questionnaire and a random sample of them was asked to provide a blood sample for hepatitis B core antibody (anti-HBc), hepatitis B surface antigen (HBsAg) and antibodies to hepatitis C (anti-HCV) testing. Individual questions or combinations of them were evaluated in terms of their ability to detect HBV or HCV(+) cases. Of 9085 eligible employees, 6074 (67%) completed the questionnaire. Of 990 samples obtained, 19.9% were anti-HBc(+), 2.6% HBsAg(+) and 0.5% anti-HCV(+). All anti-HCV(+) cases had multiple parenteral risk factors. Multiple logistic regression identified associations between anti-HBc and older age, family members with chronic hepatitis, job category and history of transfusion before 1992. HBsAg(+) was associated with older age and history of transfusion before 1992. None of the risk/prognostic factors had sufficient sensitivity and specificity for HBV but report of at least one risk factor identified all HCV(+) cases. Anti-HCV screening of those with at least two parenteral risk factors not only identified all anti-HCV(+) cases but also resulted in 86% decrease in the screening cost. Under the light of recent treatment advances, targeted questionnaire-based screening of asymptomatic people may prove to be a cost-effective way to face hepatitis C.
对17家希腊公司的员工开展了一项横断面研究，目的是评估乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）的流行情况，确定相关的预后/风险因素，并评估一份问卷作为预筛查工具的有效性。所有参与者均被要求填写一份问卷，其中随机抽取的一部分人被要求提供血样，用于检测乙肝核心抗体（抗-HBc）、乙肝表面抗原（HBsAg）和丙肝抗体（抗-HCV）。根据检测HBV或HCV阳性病例的能力，对各个问题或问题组合进行了评估。在9085名符合条件的员工中，6074人（67%）完成了问卷。在获取的990份样本中，19.9%抗-HBc阳性，2.6% HBsAg阳性，0.5%抗-HCV阳性。所有抗-HCV阳性病例均有多种经肠外途径感染的风险因素。多因素logistic回归分析确定了抗-HBc与年龄较大、有慢性肝炎家族成员、工作类别以及1992年前有输血史之间的关联。HBsAg阳性与年龄较大以及1992年前有输血史有关。对于HBV，没有一个风险/预后因素具有足够的敏感性和特异性，但报告至少一个风险因素可识别出所有HCV阳性病例。对至少有两种经肠外途径感染风险因素的人群进行抗-HCV筛查，不仅识别出了所有抗-HCV阳性病例，还使筛查成本降低了86%。鉴于最近的治疗进展，对无症状人群进行基于问卷的针对性筛查可能是应对丙型肝炎的一种具有成本效益的方法。
