Mangla Neeraj, Mamun Rifat, Weisberg Ilan S
Departments of aMedicine bDigestive Diseases, Icahn School of Medicine at Mount Sinai (Beth Israel), New York City, New York, USA.
Eur J Gastroenterol Hepatol. 2017 Nov;29(11):1215-1218. doi: 10.1097/MEG.0000000000000950.
Viral hepatitis is a global health issue and can lead to cirrhosis, liver failure, and hepatocellular carcinoma. Guidelines for viral hepatitis screening in the transgender population do not exist. Transgender patients may be at higher risk for contracting viral hepatitis due to socioeconomic and behavioral factors. The aim of this study was to measure the quality of screening, prevalence, and susceptibility of viral hepatitis, and to identify barriers to screening in transgender patients undergoing gender identity hormonal therapy.
LGBTQ-friendly clinic visits from transgender patients older than 18 years in New York City from 2012 to 2015 were reviewed.
Approximately 13% of patients were screened for any viral hepatitis on initial consultation. Screening rates for hepatitis C virus (HCV), hepatitis B virus (HBV), and hepatitis A virus (HAV) at any point were 27, 22, and 20%. HAV screening was performed in 28% of the female to male (FtM) patients and 16% of male to female (MtF) (P<0.05) patients. HBV screening was performed in 30% of FtM patients and 18% of MtF patients (P<0.05). Thirty-one percent of FtM, 24% of MtF, and 17% of genderqueer patients were tested for HCV (P>0.05). Prevalence of HCV, HBV, and HIV in FtM was 0, 0, and 0.44% and that in MtF was 1.78, 0.89, and 1.78%, respectively. Percentage of patients immune to hepatitis A in FtM and MtF subgroups were 55 and 47% (P>0.05). Percentage of patients immune to HBV in FtM and MtF subgroups were 54 and 48% (P>0.05).
This study indicates a significant lack of hepatitis screening in the transgender population and a concerning proportion of patients susceptible to disease.
病毒性肝炎是一个全球性的健康问题，可导致肝硬化、肝衰竭和肝细胞癌。目前尚无针对跨性别者群体进行病毒性肝炎筛查的指南。由于社会经济和行为因素，跨性别患者感染病毒性肝炎的风险可能更高。本研究的目的是衡量筛查质量、病毒性肝炎的患病率和易感性，并确定接受性别认同激素治疗的跨性别患者在筛查方面的障碍。
回顾了2012年至2015年纽约市年龄在18岁以上的跨性别患者在对 LGBTQ 友好的诊所的就诊情况。
约13%的患者在初次咨询时接受了任何病毒性肝炎的筛查。丙型肝炎病毒（HCV）、乙型肝炎病毒（HBV）和甲型肝炎病毒（HAV）在任何时间点的筛查率分别为27%、22%和20%。28%的女性转男性（FtM）患者和16%的男性转女性（MtF）患者（P<0.05）接受了HAV筛查。30%的FtM患者和18%的MtF患者（P<0.05）接受了HBV筛查。31%的FtM患者、24%的MtF患者和17%的性别酷儿患者接受了HCV检测（P>0.05）。FtM患者中HCV、HBV和HIV的患病率分别为0、0和0.44%，MtF患者中分别为1.78%、0.89%和1.78%。FtM和MtF亚组中对甲型肝炎有免疫力的患者百分比分别为55%和47%（P>0.05）。FtM和MtF亚组中对HBV有免疫力的患者百分比分别为54%和48%（P>0.05）。
本研究表明跨性别者群体中存在严重的肝炎筛查不足情况，且有相当比例的患者易感染疾病。
