MMWR Morb Mortal Wkly Rep. 2014 Apr 11;63(14):309-11.
An estimated 3.2 million persons in the United States have chronic infection with hepatitis C virus (HCV). Most new HCV transmissions occur among persons who inject drugs, often within the first few years of their injection drug use. During 2003-2012, reports of HCV infection increased from 15 to 54 cases per 100,000 among persons aged <30 years in Wisconsin, and 58% of persons in this age group with acute HCV infection reported injecting drugs (Wisconsin Division of Public Health, unpublished data, 2013). To increase detection of HCV infection, the Wisconsin Division of Public Health (WDPH) piloted a program during October 2012-October 2013 that offered rapid HCV testing to clients of four agencies providing outreach testing for HCV and human immunodeficiency virus infection, syringe exchange, counseling, and other harm reduction services to persons with drug dependence. During that period, 1,255 persons were tested using a rapid HCV test, and 246 (20%) of the results were positive. Most (72%) of the infections had not been reported to WDPH. A blood specimen for further testing was collected from 192 (78%) participants with positive HCV test results; among these participants, 183 were tested for HCV RNA using reverse transcription-polymerase chain reaction (RT-PCR), and these results were positive for 128 (70%) participants, indicating active infection. Use of the rapid HCV test detected previously unreported HCV infections and raised awareness of HCV. Persons identified with active HCV infection should be referred to medical care and counseled on ways to prevent HCV transmission to others.
据估计，美国有 320 万人患有慢性丙型肝炎病毒（HCV）感染。大多数新的 HCV 传播发生在注射毒品的人群中，通常是在他们开始注射毒品的最初几年内。在 2003 年至 2012 年期间，威斯康星州报告的 HCV 感染病例从每 10 万人中有 15 例增加到 54 例，年龄在 30 岁以下的人群中，有 58%的急性 HCV 感染患者报告注射毒品（威斯康星州公共卫生部，未发表的数据，2013 年）。为了增加 HCV 感染的检测，威斯康星州公共卫生部（WDPH）在 2012 年 10 月至 2013 年 10 月期间试行一项计划，为四家机构的客户提供快速 HCV 检测，这些机构为 HCV 和人类免疫缺陷病毒感染、注射器交换、咨询和其他减少药物依赖者伤害的服务提供外展检测。在此期间，有 1255 人使用快速 HCV 检测进行了检测，其中 246 人（20%）的检测结果为阳性。大多数（72%）感染病例未向 WDPH 报告。从 192 名 HCV 检测阳性结果的参与者中采集了进一步检测的血液样本；在这些参与者中，有 183 人使用逆转录聚合酶链反应（RT-PCR）检测 HCV RNA，其中 128 人（70%）的结果为阳性，表明存在活动性感染。快速 HCV 检测的使用发现了以前未报告的 HCV 感染，并提高了对 HCV 的认识。应将确诊患有活动性 HCV 感染的人转介到医疗保健机构，并就如何防止 HCV 传播给他人进行咨询。
