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根据出生年份的丙型肝炎病毒感染流行率:确定风险群体。

Prevalence of hepatitis C virus infection according to the year of birth: identification of risk groups.

机构信息

Cátedra de Virología, Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Junín 956, 4° piso, 1113, Ciudad de Buenos Aires, Argentina.

Unit of Infectious Diseases, Microbiology and Preventive Medicine, Instituto de Biomedicina de Sevilla/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Avda Manuel Siurot s/n, 41013, Seville, Spain.

出版信息

Eur J Clin Microbiol Infect Dis. 2018 Feb;37(2):247-254. doi: 10.1007/s10096-017-3123-4. Epub 2017 Oct 27.

Abstract

Hepatitis C virus (HCV) screening according to the year of birth is recommended is some countries based on epidemiological data. The aim of this study was to analyze anti-HCV prevalence among people born between 1905 and 2015 in Argentina. Patients attending a tertiary care hospital in Buenos Aires, Argentina, from 2001 to 2015, who had a determination of anti-HCV, were included. Of 22,079 patients analyzed, 1,152 (5.2%; 95% confidence interval [CI]: 4.9%-5.5%) patients showed positive anti-HCV and 729 (3.3%; 95% CI: 3.1%-3.5%) patients showed detectable viremia. Three risk groups were identified (HCV prevalence): low-risk group-outpatient clinics/emergencies (2.8%); intermediate-risk group-in-patients (8%); and high-risk group-dialysis/transplants (27.2%). In the low-risk group, being born in 1973 or before was identified as a cut-off value for the risk of anti-HCV acquisition (area under the receiver-operator characteristic curve: 75.1 [95% asymptotic CI: 0.732-0.770; p < 0.001]). Ninety-one patients born after 1973 (0.8%) showed positive anti-HCV versus 457 individuals born in 1973 or before (5.8%), p < 0.001. In this group, positive anti-HCV was observed in 252 females (2.1%) and 296 males (4.1%), p < 0.001. In a multivariate analysis adjusted for gender, alanine-aminotransferase levels and HIV coinfection, being born in 1973 or before was independently identified as a risk for positive anti-HCV (adjusted odds ratio: 14.234 [95% CI: 9.993-20.277]; p < 0.001). People born in 1973 or before without other risk factors should be included in screening programs to link the highest possible number of HCV-infected patients to appropriate care and treatment.

摘要

丙型肝炎病毒 (HCV) 根据出生年份进行筛查,这是一些国家基于流行病学数据推荐的做法。本研究的目的是分析阿根廷出生于 1905 年至 2015 年之间的人群中抗-HCV 的流行率。该研究纳入了 2001 年至 2015 年期间在阿根廷布宜诺斯艾利斯一家三级保健医院就诊的患者,这些患者均进行了抗-HCV 检测。在分析的 22079 名患者中,1152 名(5.2%;95%置信区间[CI]:4.9%-5.5%)患者抗-HCV 检测结果为阳性,729 名(3.3%;95%CI:3.1%-3.5%)患者可检测到病毒血症。确定了三个风险组(HCV 流行率):低危组-门诊/急诊(2.8%);中危组-住院患者(8%);高危组-透析/移植(27.2%)。在低危组中,出生于 1973 年或之前被确定为抗 HCV 获得风险的截断值(受试者工作特征曲线下面积:75.1[95%渐近 CI:0.732-0.770;p<0.001])。91 名出生于 1973 年以后的患者(0.8%)抗-HCV 检测结果为阳性,而 457 名出生于 1973 年或之前的患者(5.8%)抗-HCV 检测结果为阳性,p<0.001。在该组中,252 名女性(2.1%)和 296 名男性(4.1%)抗-HCV 检测结果为阳性,p<0.001。在调整性别、丙氨酸氨基转移酶水平和 HIV 合并感染的多变量分析中,出生于 1973 年或之前被确定为抗-HCV 阳性的独立危险因素(调整比值比:14.234[95%CI:9.993-20.277];p<0.001)。无其他危险因素的 1973 年或之前出生的人群应纳入筛查计划,以尽可能多地将 HCV 感染患者联系到适当的护理和治疗。

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