Vermunt Jane, Fraser Margaret, Herbison Peter, Wiles Anna, Schlup Martin, Schultz Michael
Jane Vermunt, Anna Wiles, Martin Schlup, Michael Schultz, Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin 9054, New Zealand.
World J Gastroenterol. 2015 Sep 21;21(35):10224-33. doi: 10.3748/wjg.v21.i35.10224.
To determine the prevalence of infection with hepatitis C virus (HCV) in those most at risk of advanced liver disease and to identify gaps in knowledge of HCV.
Questionnaires were mailed to randomly selected residents aged 40-59 to assess the extent of their general knowledge about HCV. The questionnaire assessed demographics, the extent of general knowledge about viral hepatitis, potential risks for infection and the prevalence of risk factors associated with increased progression of liver fibrosis. Anonymised residual laboratory blood samples from 40-59 years old people from Dunedin taken in hospital or in the community, were tested for HCV antibodies and alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyl transpeptidase (GGT). Linear regression was performed to examine whether the demographics sex, age, socio-economic status, qualification level and occupation sector (categorical variables) were predictors of level of general knowledge about hepatitis. For the demographics that were found to be significant predictors of score outcome, multiple regression analysis was used to determine independent effects. χ (2) tests were used to compare our selected sample and our responder population demographics, to the demographics of the entire 40-59 years old population in Dunedin using the 2006 NZ census data. Exact confidence intervals for the proportion positive for HCV and HBV were calculated using the binomial distribution.
The response rate to the mailed questionnaire was 431/1400 (30.8%). On average 59.4% questions were answered correctly. Predictors for higher scores, indicating greater knowledge about symptoms and transmission included sex (female, P < 0.01), higher level of qualification (P < 0.000) and occupation sector (P < 0.000). Sharing intravenous drug utensils was a known risk factor for disease transmission (94.4%), but the sharing of common household items such as a toothbrush was not. 93% of the population were unaware that HCV infection can be asymptomatic. 25% did not know that treatment was available in New Zealand and of those who did know, only 40% assumed it was funded. Six hundred and eighty-two residual anonymised blood samples were tested for HCV antibodies, ALT, AST and GGT. The prevalence for HCV was 4.01%, 95%CI: 2.6%-5.8%. Liver function tests were not useful for identifying likelyhood of HCV infection.
Prevalence of HCV in our population is high, and the majority have limited knowledge of HCV and its treatment.
确定晚期肝病高危人群中丙型肝炎病毒（HCV）感染的患病率，并找出HCV知识方面的差距。
向随机抽取的40至59岁居民邮寄调查问卷，以评估他们对HCV的一般了解程度。问卷评估了人口统计学特征、病毒性肝炎的一般知识范围、潜在感染风险以及与肝纤维化进展加快相关的危险因素的患病率。对从但尼丁医院或社区采集的40至59岁人群的匿名剩余实验室血液样本进行HCV抗体以及丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、γ-谷氨酰转肽酶（GGT）检测。进行线性回归分析，以检验人口统计学特征（性别、年龄、社会经济地位、学历水平和职业领域，分类变量）是否为肝炎一般知识水平的预测因素。对于被发现是得分结果显著预测因素的人口统计学特征，使用多元回归分析来确定独立影响。使用χ²检验，将我们选定的样本和应答人群的人口统计学特征与2006年新西兰人口普查数据中但尼丁整个40至59岁人群的人口统计学特征进行比较。使用二项分布计算HCV和HBV阳性比例的确切置信区间。
邮寄问卷的回复率为431/1400（30.8%）。平均正确回答的问题比例为59.4%。得分较高（表明对症状和传播有更多了解）的预测因素包括性别（女性，P<0.01）、较高的学历水平（P<0.000）和职业领域（P<0.000）。共用静脉注射吸毒器具是已知的疾病传播风险因素（94.4%），但共用牙刷等普通家庭用品则不是。93%的人群不知道HCV感染可能无症状。25%的人不知道新西兰有治疗方法，而在知道的人中，只有40%的人认为治疗是有资金支持的。对682份匿名剩余血液样本进行了HCV抗体、ALT、AST和GGT检测。HCV患病率为4.01%，95%置信区间：2.6%-5.8%。肝功能检查对确定HCV感染可能性没有帮助。
我们人群中HCV患病率较高，但大多数人对HCV及其治疗的了解有限。
