克罗地亚10年期间慢性丙型肝炎患者延迟就医的趋势。

Trends of Late Presentation to Care in Patients with Chronic Hepatitis C during a 10-Year Period in Croatia.

作者信息

Papic Neven, Radmanic Leona, Dusek Davorka, Kurelac Ivan, Zidovec Lepej Snjezana, Vince Adriana

机构信息

Department of Viral Hepatitis, University Hospital for Infectious Diseases, 10 000 Zagreb, Croatia.

School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia.

出版信息

Infect Dis Rep. 2020 Nov 11;12(3):74-81. doi: 10.3390/idr12030016.

DOI:10.3390/idr12030016

PMID:33187150

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7768519/

Abstract

Late presentation to care is the major obstacle to receiving treatment for chronic hepatitis C (CHC). Our aim was to analyze the prevalence and trends of late presenters (LP) at first consultations in Croatia during a 10-year period. This retrospective cross-sectional study included all adult CHC patients ( = 854) entering specialist medical care at the University Hospital for Infectious Diseases Zagreb between 2009 and 2018. LP was defined as liver stiffness measurement ≥ 9.5 kPa or biopsy METAVIR F ≥ 3. During the study period, mean patients' age increased from 37 to 52 years while HCV genotype distribution changed leading to the replacement of genotype 1b with 1a (g1b 32% to 21%; g1a 19% to 38%). A total of 320 (37.4%) were LP; they were older (47.5, IQR 40.5-57.6), and more commonly infected with g1b (34.1%) and g3 (42.5%). The prevalence of LP significantly increased from 31.9% in 2009 to 46.5% in 2018. Late presentation for care of CHC is increasing in Croatia suggesting a gap of diagnosing strategies in patients over 50 years.

摘要

延迟就医是慢性丙型肝炎（CHC）接受治疗的主要障碍。我们的目的是分析克罗地亚10年间初次就诊时延迟就诊者（LP）的患病率及趋势。这项回顾性横断面研究纳入了2009年至2018年间在萨格勒布大学传染病医院接受专科医疗护理的所有成年CHC患者（n = 854）。LP定义为肝脏硬度测量值≥9.5 kPa或活检METAVIR F≥3。在研究期间，患者的平均年龄从37岁增加到52岁，同时HCV基因型分布发生变化，导致1b型被1a型取代（1b型从32%降至21%；1a型从19%升至38%）。共有320例（37.4%）为LP；他们年龄更大（47.5岁，四分位距40.5 - 57.6岁），更常见感染1b型（34.1%）和3型（42.5%）。LP的患病率从2009年的31.9%显著增加到2018年的46.5%。在克罗地亚，CHC延迟就医的情况正在增加，这表明50岁以上患者的诊断策略存在差距。