Health Protection Agency Centre for Infections, London, UK.
Eur J Public Health. 2012 Apr;22(2):187-92. doi: 10.1093/eurpub/ckr083. Epub 2011 Jun 26.
Previous evidence synthesis estimates of Hepatitis C Virus (HCV) in England did not consider excess HCV risk in ethnic minority populations. We incorporate new information on HCV risk among non-injectors by ethnic group, and additional information on injecting prevalence in order to generate new and updated estimates of HCV prevalence risk in England for 2005.
Bayesian evidence synthesis was used to combine multiple sources of data that directly or indirectly provide information on the populations at risk, or prevalence of HCV infection. HCV data were modelled by region, age group and sex as well as ethnicity for never-injectors and by injecting status (ex and current).
Overall HCV antibody prevalence in England was estimated at 0.67% [95% credible interval (95% CrI): 0.50-0.94] of those aged 15-59 years, or 203 000 (153 000, 286 000) individuals. HCV prevalence in never-injectors remains low, even after accounting for ethnicity, with a prevalence of 0.05% (95% CrI 0.03-0.10) in those of white/other ethnicity and 0.76% (0.48-1.23) in South Asians. Estimates are similar to 2003, although patterns of injecting drug use are different, with an older population of current injecting drug users and lower estimated numbers of ex-injectors, but higher HCV prevalence.
Incorporating updated information, including data on ethnicity and improved data on injectors, gave similar overall estimates of HCV prevalence in England. Further information on HCV in South Asians and natural history of injecting are required to reduce uncertainty of estimates. This method may be applied to other countries and settings.
之前对英格兰丙型肝炎病毒 (HCV) 的综合评估并未考虑少数族裔人群中 HCV 风险的增加。我们结合了新的关于非注射者按族裔分组的 HCV 风险信息，以及更多关于注射流行率的信息，以便为英格兰 2005 年 HCV 流行率风险生成新的和更新的估计。
使用贝叶斯证据综合来结合多种直接或间接提供风险人群或 HCV 感染流行率信息的数据来源。HCV 数据按地区、年龄组和性别以及非注射者的族裔进行建模，还按注射状态（既往和现患）进行建模。
15-59 岁人群中，英格兰 HCV 抗体总流行率估计为 0.67%（95%可信区间：0.50-0.94），即 203000 人（153000-286000）。即使考虑到族裔因素，非注射者的 HCV 流行率仍然很低，白种人/其他族裔的流行率为 0.05%（95%CrI：0.03-0.10），南亚裔的流行率为 0.76%（0.48-1.23）。与 2003 年相比，估计值相似，但注射毒品使用模式有所不同，现患注射毒品使用者的年龄较大，既往注射毒品使用者的估计人数较少，但 HCV 流行率较高。
纳入更新的信息，包括族裔信息和关于注射者的更准确数据，使英格兰 HCV 流行率的总体估计值相似。需要进一步了解南亚人群中的 HCV 情况和注射的自然史，以减少估计的不确定性。这种方法可以应用于其他国家和环境。
