Department of Medicine, Division of Infectious Diseases and HIV Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America.
Department of Medicine, Division of General Internal Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America.
PLoS One. 2020 Jul 9;15(7):e0235778. doi: 10.1371/journal.pone.0235778. eCollection 2020.
In 2012, the Centers for Disease Control and Prevention released updated guidelines recommending universal, one-time hepatitis C virus screening for all individuals born between 1945 and 1965. Prior to the implementation of these guidelines, testing rates were inappropriately low, but unnecessary duplicate antibody testing was also problematic. In the era of increased efforts to screen "baby boomers", the prevalence and social determinants of initial and duplicate hepatitis C testing have not been well described.
A hepatitis C screening program was implemented at six urban primary care clinics affiliated with Drexel University College of Medicine. Data was collected regarding the screening patterns in these clinics. Annual screening rates for the program were assessed. Multivariate logistic regression analyses were used to examine the association of demographic variables and the outcomes of subjects having ever been tested and subjects having received duplicate testing.
Following the implementation of the program, the screening rate increased from 16% in the first year of analysis to 82% in the final year of analysis. Of the 6,717 patients screened, 1,207 had duplicate testing, of which 14% had inappropriate duplicate antibody screening. African Americans and Asian patients had a higher odds of being screened. Patients with public insurance had a higher odds of duplicate screening.
In the setting of an aggressive hepatitis C screening program, high testing rates may be attained in a target population. However, inappropriate duplicate antibody testing rates may be high, which may be a burden in resource-limited settings.
2012 年，疾病控制与预防中心发布了更新的指南，建议对所有 1945 年至 1965 年期间出生的人群进行一次性的丙型肝炎病毒普遍筛查。在这些指南实施之前，检测率过低，但不必要的重复抗体检测也是一个问题。在加大筛查“婴儿潮一代”力度的时代，初始和重复丙型肝炎检测的流行情况和社会决定因素尚未得到很好的描述。
在六家与德雷克塞尔大学医学院附属的城市初级保健诊所实施了丙型肝炎筛查计划。收集了这些诊所的筛查模式数据。评估了该计划的年度筛查率。采用多变量逻辑回归分析来检查人口统计学变量与曾经接受过检测的受试者和接受过重复检测的受试者的结局之间的关联。
在该计划实施后，筛查率从分析的第一年的 16%增加到分析的最后一年的 82%。在 6717 名接受筛查的患者中，有 1207 名进行了重复检测，其中 14%的重复抗体检测不适当。非裔美国人和亚裔患者的筛查几率更高。有公共保险的患者重复检测的几率更高。
在积极的丙型肝炎筛查计划中，目标人群的检测率可能会很高。然而，不适当的重复抗体检测率可能很高，这在资源有限的环境中可能是一个负担。
