中国东北地区沈阳市丙型肝炎病毒感染的流行状况和特征，以及根据血清抗-HCV 水平预测 HCV RNA 阳性：医院数据的回顾性分析。
Prevalence and characteristics of hepatitis C virus infection in Shenyang City, Northeast China, and prediction of HCV RNA positivity according to serum anti-HCV level: retrospective review of hospital data.
机构信息
Department of Infectious Diseases, Shengjing Hospital of China Medical University, Shenyang, Liaoning, P.R. China, 110004.
Department of Health Statistics, School of Public Health, China Medical University, Shenyang, Liaoning, P.R. China, 110122.
出版信息
Virol J. 2020 Mar 16;17(1):36. doi: 10.1186/s12985-020-01316-y.
OBJECTIVE
The prevalence of hepatitis C virus (HCV) infection is typically evaluated based on the current rate of positivity of anti-HCV antibody; however, HCV RNA positivity is considered the main criterion for antiviral treatment of HCV infection in the clinical setting. In this study, we evaluated the prevalence of HCV infection based on anti-HCV and HCV RNA detection in the population of Liaoning Province, and investigated the correlation between serum HCV RNA positivity and anti-HCV levels.
METHODS
A total of 192,202 patients who underwent serum anti-HCV examination at Shengjing Hospital in 2018 were enrolled in the study. Anti-HCV production was tested using a chemiluminescence assay, and serum HCV RNA detection was performed with Roche COBAS TaqMan (CTM) Analyzer.
RESULTS
The prevalence of anti-HCV was 1.21 and 0.93% among male and female patients in Liaoning Province, respectively. The positive rates of anti-HCV and serum anti-HCV levels were both age-related, in which patients over 40 years of age had a significantly higher anti-HCV positive rate than those younger than 40 years. Among the anti-HCV-positive patients, the average HCV RNA positive rate was 51.66 and 35.93% in males and females, respectively. Spearman rank analysis showed a significantly positive correlation between serum HCV RNA positivity and the level of anti-HCV. The best cut-off value using serum anti-HCV levels to predict the positivity of HCV RNA was determined to be 9.19 signal-to-cut-off ratio (s/co) in males and 10.18 s/co in females.
CONCLUSION
The prevalence of anti-HCV in the general population of Liaoning Province was around 1.04%, which was higher than that previously reported from a national survey of HCV infection in China. Approximately 42.9% of the anti-HCV-positive patients also tested positive for HCV RNA. However, the positive correlation between the serum anti-HCV and HCV RNA levels suggests that the positivity of serum HCV RNA can be predicted according to the anti-HCV level in anti-HCV-positive patients, which can improve screening and facilitate timely intervention to prevent the spread of infection.
目的
丙型肝炎病毒 (HCV) 感染的流行率通常基于抗 HCV 抗体的当前阳性率进行评估；然而，在临床环境中，HCV RNA 阳性被认为是 HCV 感染抗病毒治疗的主要标准。在这项研究中，我们评估了辽宁省人群中基于抗 HCV 和 HCV RNA 检测的 HCV 感染流行率，并研究了血清 HCV RNA 阳性与抗 HCV 水平之间的相关性。
方法
本研究共纳入 2018 年在盛京医院接受血清抗 HCV 检查的 192202 例患者。使用化学发光法检测抗 HCV 的产生，使用罗氏 COBAS TaqMan（CTM）分析仪检测血清 HCV RNA。
结果
辽宁省男性和女性患者的抗 HCV 流行率分别为 1.21%和 0.93%。抗 HCV 和血清抗 HCV 水平的阳性率均与年龄相关，其中 40 岁以上患者的抗 HCV 阳性率明显高于 40 岁以下患者。在抗 HCV 阳性患者中，男性和女性的平均 HCV RNA 阳性率分别为 51.66%和 35.93%。Spearman 秩分析显示，血清 HCV RNA 阳性与抗 HCV 水平之间存在显著正相关。使用血清抗 HCV 水平预测 HCV RNA 阳性的最佳截断值在男性中为 9.19 信号与切割比（s/co），在女性中为 10.18 s/co。
结论
辽宁省普通人群的抗 HCV 流行率约为 1.04%，高于中国全国 HCV 感染调查的先前报告。大约 42.9%的抗 HCV 阳性患者 HCV RNA 也呈阳性。然而，血清抗 HCV 与 HCV RNA 水平之间的正相关表明，可以根据抗 HCV 阳性患者的抗 HCV 水平预测血清 HCV RNA 的阳性，这可以提高筛查效率，并有助于及时干预，防止感染传播。
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