Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Braz J Infect Dis. 2019 Jan-Feb;23(1):34-39. doi: 10.1016/j.bjid.2019.01.006. Epub 2019 Mar 6.
Hepatitis C is an important health problem. In Brazil, 1-2 million people are infected. Despite this expressive number, and the availability of very successful treatment, many patients remained undiagnosed mainly because of the asymptomatic nature of the infection.
To describe epidemiological characteristics of HCV-infected patients seen at referral centers in Brazil, the source of referral, and the time spanned to reach a reference center, in order to improve the identification of undiagnosed patients.
Multicenter observational, cross-sectional study carried out in 15 centers of Brazil, between January/2016 and June/2017. Data of patients with a confirmed diagnosis (anti-HCV and HCV-RNA) were collected by interview using standard questionnaires and by review of charts.
Two thousand patients were included; 55.1% were male, mean age 58±11 years. Only 14.9% had higher education and 84.2% received up to five monthly minimum Brazilian wages (approximately US$260.00/month). The time between diagnosis and beginning of follow-up was 22.9 months. The most common reasons for testing were check-up (33.2%) and blood donation (19%). General practitioners diagnosed most of the patients (30.1%). Fibrosis stage was mainly evaluated by liver biopsy (61.5%) and 31.3% of the patients were cirrhotic at diagnosis.
This multicenter Brazilian study showed that the mean time to reach a referral center for treatment was almost two years. Primary care physicians diagnoses most hepatitis C cases in the country. Population campaigns and medical education should be encouraged to intensify screening of asymptomatic individuals, considering the efficiency of check-ups in identifying new patients.
丙型肝炎是一个重要的健康问题。在巴西，有 100 万到 200 万人感染。尽管感染人数众多，且治疗方法非常有效，但许多患者仍未被诊断出来，主要是因为感染通常无症状。
描述在巴西转诊中心就诊的 HCV 感染患者的流行病学特征、转诊来源和到达转诊中心所需的时间，以便更好地发现未确诊患者。
这是一项在巴西 15 个中心进行的多中心观察性、横断面研究，时间为 2016 年 1 月至 2017 年 6 月。通过使用标准问卷进行访谈和查阅图表收集已确诊（抗 HCV 和 HCV-RNA）患者的数据。
共纳入 2000 例患者，其中 55.1%为男性，平均年龄 58±11 岁。仅有 14.9%的患者受过高等教育，84.2%的患者月收入为 5 个巴西最低工资（约 260.00 美元/月）。从诊断到开始随访的时间为 22.9 个月。检测的最常见原因是体检（33.2%）和献血（19%）。大多数患者由全科医生诊断（30.1%）。纤维化分期主要通过肝活检评估（61.5%），诊断时 31.3%的患者为肝硬化。
这项巴西多中心研究表明，患者到达治疗转诊中心的平均时间接近两年。初级保健医生是该国诊断丙型肝炎病例最多的医生。应鼓励开展人群宣传和医学教育活动，加强对无症状人群的筛查，考虑到体检在发现新患者方面的效率。
