Chen Yun-Yuan, Chen Chi-Ling, Chen Jen-Wei, Hsu Nien-Tzu, Wei Sheng-Tang, Hou Sheng-Mou, Lu Sheng-Nan, Chen Pei-Jer
Head Office Taiwan Blood Services Foundation Taipei Taiwan.
Graduate Institute of Clinical Medicine College of Medicine National Taiwan University Taipei Taiwan.
Hepatol Commun. 2020 Jun 4;4(8):1193-1205. doi: 10.1002/hep4.1531. eCollection 2020 Aug.
The prevalence of hepatitis C virus (HCV) infection in Taiwan was approximately 4% a decade ago, much higher than the worldwide average. This study aimed to assess the HCV burden among 4 million voluntary blood donors after 2 decades of prevention and treatment policies. We retrieved screening results for anti-HCV and HCV RNA from the Database for Evaluating Voluntary Taiwanese Eligible Donors. First-time blood donors who donated blood after 1999 and repeat donors who donated blood more than once between 2013 and 2017 were included to estimate HCV prevalence and incidence, respectively. The Cox proportional hazards model was used to estimate hazard ratios. Geographic variation in HCV prevalence and incidence in 364 townships was also analyzed. The prevalence study included 3,656,598 first-time donors. The overall crude prevalence of anti-HCV decreased from 15.5 to 4.5 per 1,000 donors between 1999 and 2017. Younger birth cohorts had a significantly lower prevalence of anti-HCV. The majority of townships (64.3%) in Taiwan showed a significantly decreased prevalence. The incidence study included 1,393,014 repeat donors followed for 3,436,607 person-years. Ninety-eight donors seroconverted to HCV RNA positivity, resulting in an HCV incidence of 2.9 per 100,000 person-years. Donors living in townships where HCV RNA prevalence was greater than 2 per 1,000 had at least 2.5-fold greater risk of new HCV infection. HCV prevalence in Taiwanese first-time blood donors decreased by 71% in the last 2 decades. However, townships with higher HCV prevalence also showed higher HCV incidence and require more active intervention.
十年前，台湾丙型肝炎病毒（HCV）感染率约为4%，远高于全球平均水平。本研究旨在评估在实施了二十年的预防和治疗政策后，400万自愿献血者中的HCV负担情况。我们从台湾自愿合格献血者评估数据库中检索了抗-HCV和HCV RNA的筛查结果。纳入1999年后首次献血的献血者以及2013年至2017年间多次献血的重复献血者，分别用于估计HCV感染率和发病率。采用Cox比例风险模型估计风险比。还分析了364个乡镇HCV感染率和发病率的地理差异。感染率研究纳入了3,656,598名首次献血者。1999年至2017年间，抗-HCV的总体粗感染率从每1000名献血者中的15.5例降至4.5例。较年轻的出生队列抗-HCV感染率显著较低。台湾大多数乡镇（64.3%）的感染率显著下降。发病率研究纳入了1,393,014名重复献血者，随访3,436,607人年。98名献血者血清转化为HCV RNA阳性，HCV发病率为每10万人年2.9例。居住在HCV RNA感染率高于每1000人中2例的乡镇的献血者，新感染HCV的风险至少高2.5倍。在过去二十年中，台湾首次献血者的HCV感染率下降了71%。然而，HCV感染率较高的乡镇HCV发病率也较高，需要更积极的干预措施。
