Division of Allergy and Infectious Diseases, University of Washington, Seattle WA, USA.
BMC Infect Dis. 2011 Jun 6;11:160. doi: 10.1186/1471-2334-11-160.
In the United States, about 70% of 2.9-3.7 million people with hepatitis C (HCV) are unaware of their infection. Although universal screening might be a cost-effective way to identify infections, prevent morbidity, and reduce transmission, few efforts have been made to determine patient opinions about new approaches to screening.
We surveyed 200 patients in August 2010 at five outpatient clinics of a major public urban medical center in Seattle, WA, with an 85.8% response rate.
The sample was 55.3% women, median 47 years of age, and 56.3% white and 32.7% African or African-American; 9.5% and 2.5% reported testing positive for HCV and HIV, respectively. The vast majority of patients supported universal screening for HCV. When presented with three options for screening, 48% preferred universal testing without being informed that they were being tested or provided with negative results, 37% preferred testing with the chance to "opt-out" of being tested and without being provided with negative results, and 15% preferred testing based on clinician judgment. Results were similar for HIV screening.
Patients support universal screening for HCV, even if that screening involves testing without prior consent or the routine provision of negative test results. Current screening guidelines and procedures should be reconsidered in light of patient priorities.
在美国，约有 290 万至 370 万丙型肝炎（HCV）感染者中有 70%不知道自己被感染了。虽然普遍筛查可能是一种识别感染、预防发病和减少传播的具有成本效益的方法，但很少有努力来确定患者对新筛查方法的看法。
我们于 2010 年 8 月在西雅图的一家主要公立城市医疗中心的五家门诊诊所对 200 名患者进行了调查，应答率为 85.8%。
样本中 55.3%为女性，中位年龄为 47 岁，56.3%为白人，32.7%为非裔或非裔美国人；9.5%和 2.5%报告 HCV 和 HIV 检测呈阳性。绝大多数患者支持对 HCV 进行普遍筛查。当提供三种筛查方案时，48%的患者更喜欢不事先通知或不提供阴性结果的普遍检测，37%的患者更喜欢有“选择退出”检测的机会而不提供阴性结果的检测，15%的患者更喜欢根据临床医生的判断进行检测。对 HIV 筛查的结果也相似。
患者支持对 HCV 进行普遍筛查，即使这种筛查涉及在没有事先同意或常规提供阴性检测结果的情况下进行检测。应根据患者的优先事项重新考虑当前的筛查指南和程序。
