Boaz Kathy, Fiore Anthony E, Schrag Stephanie J, Gonik Bernard, Schulkin Jay
National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Infect Dis Obstet Gynecol. 2003;11(1):39-44. doi: 10.1155/S106474490300005X.
Obstetrician-gynecologists are important providers of primary health care to women, and the hepatitis C virus (HCV) infection screening practices and recommendations provided by obstetrician-gynecologists for HCV-infected patients are unknown.
We surveyed American College of Obstetricians and Gynecologists (ACOG) Fellows, including 413 Fellows who were participating in the Collaborative Ambulatory Research Network (CARN) and 650 randomly sampled Fellows, about HCV screening and counseling practices.
In total, 74% of CARN members and 44% of non-CARN members responded. Demographics and practice structure were similar between the two groups. More than 80% of providers routinely collected drug use and blood transfusion histories from their patients. Of the respondents, 49% always screened for HCV infection when patients had a history of injection drug use, and 35% screened all patients who had received a blood transfusion before 1992. For HCV-infected patients, 47% of the physicians always advised against breastfeeding, 70% recommended condom use with a long-term steady partner, and 64% advised against alcohol consumption. Respondents who considered themselves to be primary care providers were no more likely to screen or provide appropriate counseling messages than were other providers.
Most obstetrician-gynecologists are routinely collecting information that can be used to assess HCV infection risk, but HCV screening practices and counseling that are provided for those with HCV infection are not always consistent with current Centers for Disease Control and Prevention and ACOG recommendations.
妇产科医生是女性初级卫生保健的重要提供者,然而妇产科医生针对丙型肝炎病毒(HCV)感染患者的筛查实践及建议尚不清楚。
我们对美国妇产科医师学会(ACOG)会员进行了调查,其中包括413名参与门诊协作研究网络(CARN)的会员以及650名随机抽取的会员,调查内容涉及HCV筛查及咨询实践。
总体而言,CARN成员中有74%以及非CARN成员中有44%进行了回复。两组在人口统计学特征及执业结构方面相似。超过80%的医疗服务提供者会常规收集患者的药物使用及输血史。在受访者中,49%在患者有注射吸毒史时总会对其进行HCV感染筛查,35%会对所有在1992年之前接受过输血的患者进行筛查。对于HCV感染患者,47%的医生总是建议不要母乳喂养,70%建议与长期固定伴侣使用避孕套,64%建议不要饮酒。自认为是初级保健提供者的受访者并不比其他提供者更有可能进行筛查或提供适当的咨询信息。
大多数妇产科医生会常规收集可用于评估HCV感染风险的信息,但针对HCV感染患者的HCV筛查实践及咨询并不总是与美国疾病控制与预防中心及ACOG目前的建议一致。