Department of Tropical Health, High Institute of Public Health, Alexandria University, Egypt.
Department of Biostatistics, High Institute of Public Health, Alexandria University, Egypt.
J Med Virol. 2016 Oct;88(10):1767-75. doi: 10.1002/jmv.24520. Epub 2016 Mar 21.
Asymptomatic patients with HCV infection identified through screening program could benefit not only from treatment but also from other interventions such as counseling to maintain health and avoid risk behaviors. This might prevent the spread of infection and result in significant public health benefits. However, mass screening would quickly deplete resources. This work aims to develop a brief HCV risk assessment questionnaire that inquires initially about a wide range of risk factors found to be potentially associated with HCV infection in order to identify the few most significant questions that could be quickly used to facilitate cost-effective HCV case-finding in the general population in Egypt. An exhaustive literature search was done to include all reported HCV risk factors that were pooled in a 65 item questionnaire. After an initial pilot study, a case-control study was performed that included 1,024 cases and 1,046 controls. In a multivariable model, a list of independent risk factors were found to be significant predictors for being HCV seropositive among two age strata (<45 and >45 years) for each gender. A simplified model that assigned values of the odds ratio as a weight for each factor present predicted HCV infection with high diagnostic accuracy. Attaining the defined cut-off value of the total risk score enhances the effectiveness of screening. HCV risk factors in the Egyptian population vary by age and gender. An accurate prediction screening tool can be used to identify those at high risk who may benefit most from HCV serologic testing. These results are to be further validated in a large scale cross-sectional study to assess the wider use of this tool. J. Med. Virol. 88:1767-1775, 2016. © 2016 Wiley Periodicals, Inc.
通过筛查项目发现的无症状 HCV 感染患者不仅可以从治疗中受益，还可以从其他干预措施中受益，例如咨询以保持健康和避免危险行为。这可能会阻止感染的传播，并带来重大的公共卫生效益。然而，大规模筛查将迅速耗尽资源。本研究旨在开发一种简短的 HCV 风险评估问卷，该问卷最初询问广泛的风险因素，这些因素被发现与 HCV 感染有潜在关联，以确定少数最显著的问题，这些问题可以快速用于促进在埃及普通人群中进行具有成本效益的 HCV 病例发现。进行了全面的文献检索，以包括所有报告的 HCV 风险因素，并将其汇总到一个包含 65 个项目的问卷中。在初步试点研究之后，进行了一项病例对照研究，其中包括 1024 例病例和 1046 例对照。在多变量模型中，发现一系列独立的风险因素是两个年龄组（<45 岁和>45 岁）中每一种性别 HCV 血清阳性的显著预测因素。一个简化的模型，为每个存在的因素分配优势比的值作为权重，可预测 HCV 感染，具有较高的诊断准确性。达到总风险评分的定义截止值可提高筛查的有效性。埃及人口的 HCV 风险因素因年龄和性别而异。一种准确的预测筛选工具可用于识别高危人群，他们可能从 HCV 血清学检测中获益最大。这些结果将在一项大规模的横断面研究中进一步验证，以评估该工具的更广泛应用。J. Med. Virol. 88:1767-1775, 2016. © 2016 Wiley Periodicals, Inc.
