VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Weill Cornell Medical College, New York, NY, USA.
Liver Int. 2021 Jan;41(1):76-80. doi: 10.1111/liv.14681. Epub 2020 Oct 10.
Rate of SARS-CoV-2 infection and impact of liver fibrosis stage upon infection rates in persons with hepatitis C virus (HCV) infection are unknown.
We retrospectively analysed the Electronically Retrieved Cohort of HCV Infected Veterans (ERCHIVES), a well-established database of HCV-infected Veterans in care. We excluded those with missing FIB-4 score and those with HIV or hepatitis B virus co-infection. We determined the number of persons tested, proportion who tested positive for SARS-CoV-2 and the infection rate by age and liver fibrosis stage.
Among 172,235 persons with HCV, 14,305 (8.3%) were tested for SARS-CoV-2 infection and 892 (6.2%) tested positive. Those with SARS-CoV-2 infection were older, more likely to be Black (55.2% vs 37.8%), obese (body mass index >30 kg/m 36.2% vs 29.7%) and have diabetes or stroke (P < .0001 for all comparisons). Mean FIB-4 scores and proportion of persons with cirrhosis (based on a FIB-4 > 3.25) were similar in both groups. Incidence rate/1,000 tested persons was much higher among Blacks (88.4; 95% CI 81.1, 96.2) vs Whites (37.5; 95% CI 33.1, 42.4) but similar among those with cirrhosis (FIB-4 > 3.25). The rates were also similar among those who were untreated for HCV vs those treated with or without attaining a sustained virologic response.
Testing rates among persons with HCV are very low. Persons with infection are more likely to be Black, have a higher body mass index and diabetes or stroke. The degree of liver fibrosis does not appear to have an impact on infection rate.
SARS-CoV-2 感染率以及丙型肝炎病毒 (HCV) 感染者肝纤维化分期对感染率的影响尚不清楚。
我们回顾性分析了电子检索的 HCV 感染退伍军人队列 (ERCHIVES)，这是一个成熟的 HCV 感染退伍军人数据库。我们排除了那些 FIB-4 评分缺失和 HIV 或乙型肝炎病毒合并感染的患者。我们确定了检测人数、SARS-CoV-2 检测阳性的比例以及按年龄和肝纤维化分期计算的感染率。
在 172235 名 HCV 感染者中，有 14305 人（8.3%）接受了 SARS-CoV-2 感染检测，其中 892 人（6.2%）检测结果为阳性。感染 SARS-CoV-2 的患者年龄更大，更有可能是黑人（55.2%比 37.8%）、肥胖（体重指数 >30kg/m 36.2%比 29.7%）且患有糖尿病或中风（所有比较 P<.0001）。两组的平均 FIB-4 评分和肝硬化患者比例（基于 FIB-4>3.25）相似。黑人的发病率/每 1000 名检测者（88.4；95%CI 81.1，96.2）远高于白人（37.5；95%CI 33.1，42.4），但肝硬化患者（FIB-4>3.25）的发病率相似。未接受 HCV 治疗者与接受治疗者（无论是否达到持续病毒学应答）的发病率也相似。
HCV 感染者的检测率非常低。感染者更有可能是黑人，体重指数更高，患有糖尿病或中风。肝纤维化程度似乎对感染率没有影响。
