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胃肠病学和肝病学诊所中新筛查出的丙型肝炎与已确诊的丙型肝炎之间的风险因素分析

Risk Factor Analysis Between Newly Screened and Established Hepatitis C in GI and Hepatology Clinics.

作者信息

Hossain Newaz, Puchakayala Bharat, Kanwar Pushpjeet, Verma Siddharth, Abraham George, Ivanov Zhanna, Niaz Muhammad Obaid, Mohanty Smruti R

机构信息

Department of Gastroenterology and Hepatobiliary Disease, New York Presbyterian Brooklyn Methodist Hospital, 506, 6th Street, Brooklyn, NY, 11215, USA.

Department of Gastroenterology and Hepatology, Icahn School of Medicine at Mt Sinai, Queens Hospital Center, 82-68, 164th Street, Queens, NY, 11432, USA.

出版信息

Dig Dis Sci. 2017 Nov;62(11):3193-3199. doi: 10.1007/s10620-017-4754-0. Epub 2017 Sep 14.

Abstract

BACKGROUND

Several studies show inconsistencies in the rate of hepatitis C virus (HCV) detection among baby boomers (born 1945-1965). We conducted a cross-sectional HCV screening followed by a case-controlled comparison of the newly screened population with established HCV subjects.

METHOD

Enrollment was offered to subjects aged 40-75 at our gastroenterology and hepatology clinics. Demographic data and potential risk factors were obtained, and HCV antibody test was offered to those who had never been screened and compared with a group with established HCV. Logistic regression analysis and Fisher's exact test were performed.

RESULTS

Six hundred and seventy-five patients were offered participation, of whom 128 declined while 50 consented to participate but did not perform the HCV antibody test. Of 497 enrolled subjects, 252 patients had HCV, while 245 subjects (188 patients among "baby boomer") underwent screening for HCV. There were more females (62.4 vs. 41.7%) and immigrants (34.7 vs. 22.2%) among the newly screened group. Among the screened population, five patients had HCV antibody (2.04%), and two of them had positive viral load (0.82%) of whom only one fell in the baby boomer category (0.53%). Compared to HCV group, screened group had significantly lower-risk factors, such as IV drug use (1.22 vs. 43.3%), intranasal cocaine use (14.3 vs. 49.6%), and blood transfusion (18.8 vs. 32.5%).

CONCLUSION

We found a slightly lower but similar prevalence of HCV antibody when screening based on birth cohort as compared to larger baby boomer studies. Future studies evaluating addition of other screening strategies or possibly universal screening may be needed.

摘要

背景

多项研究表明,婴儿潮一代(出生于1945年至1965年)中丙型肝炎病毒(HCV)的检测率存在不一致情况。我们进行了一项横断面HCV筛查,随后对新筛查人群与已确诊HCV的受试者进行病例对照比较。

方法

在我们的胃肠病学和肝病诊所,邀请40至75岁的受试者参与。获取人口统计学数据和潜在风险因素,并为从未接受过筛查的受试者提供HCV抗体检测,并与已确诊HCV的组进行比较。进行了逻辑回归分析和费舍尔精确检验。

结果

675名患者被邀请参与,其中128人拒绝,50人同意参与但未进行HCV抗体检测。在497名登记受试者中,252名患者患有HCV,而245名受试者(“婴儿潮一代”中有188名患者)接受了HCV筛查。新筛查组中的女性(62.4%对41.7%)和移民(34.7%对22.2%)更多。在筛查人群中,5名患者HCV抗体呈阳性(2.04%),其中2人病毒载量呈阳性(0.82%),其中只有1人属于婴儿潮一代(0.53%)。与HCV组相比,筛查组的风险因素显著较低,如静脉注射吸毒(1.22%对43.3%)、鼻内使用可卡因(14.3%对49.6%)和输血(18.8%对32.5%)。

结论

与规模更大的婴儿潮一代研究相比,我们发现基于出生队列进行筛查时,HCV抗体的患病率略低但相似。未来可能需要进行评估其他筛查策略或可能的普遍筛查的研究。

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