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基于医院人群筛查的丙型肝炎病毒(HCV)感染患病率及危险因素,罗马尼亚医疗机构丙型肝炎病毒感染微观消除的第一步——丙型肝炎警报研究结果

The Prevalence of HCV Infection and Risk Factors in a Hospital- Based Population Screening, a First Step to the Micro-Elimination of HCV Infection in Medical Institutions from Romania - Results of the HepC ALERT Study.

作者信息

Gheorghe Liana, Iacob Speranta, Csiki Irma Eva, Huiban Laura, Cojocaru Monica, Cojocariu Camelia, Nemteanu Roxana, Girleanu Irina, Sirli Roxana, Singeap Ana Maria, Pop Corina, Dumitrascu Dan L, Vadan Roxana, Iacob Razvan, Diculescu Mircea, Trifan Anca, Sporea Ioan, Gheorghe Cristian

机构信息

Digestive Diseases and Liver Transplantation Center, Fundeni Clinical Institute, Bucharest; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. .

Digestive Diseases and Liver Transplantation Center, Fundeni Clinical Institute, Bucharest; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.

出版信息

J Gastrointestin Liver Dis. 2020 Dec 12;29(4):587-593. doi: 10.15403/jgld-3084.

Abstract

BACKGROUND AND AIMS

Elimination of hepatitis C worldwide is more feasible if micro-elimination screening strategies are adopted. We aimed to screen hepatitis C virus (HCV) in specific high-risk populations in certain sub-regions of Romania and link them to antiviral treatment.

METHODS

A multicenter prospective study was conducted among the hospitalized or ambulatory adult patients from March 2019 to March 2020 in more than 20 medical institutions from 4 Romanian cities (Bucharest, Iasi, Timisoara, Cluj-Napoca). A rapid diagnostic test for HCV diagnosis was performed to all admitted patients and the positive ones were sent to gastroenterology departments for confirming the active infection, staging and treatment prescription.

RESULTS

In total, 25,141 subjects signed the informed consent and were consequently enrolled into the study. The prevalence of anti-HCV antibodies was 1.39% (95%CI: 1.25-1.54) and increased with the number of risk factors presented by one subject. There was a positive association between the presence of anti-HCV antibodies and female gender (p<0.001), rural area of residence (p<0.001), advanced age (p<0.001), as well as a negative association with the education level (p<0.001).

CONCLUSIONS

In a hospital-based screening micro-elimination program in Romania, HCV prevalence was lower than previously reported. This is a first step towards a cost-effective screening in a well-defined group of persons at risk and provides sufficient capacity to deliver access to HCV treatment and linkage to care in Romania.

摘要

背景与目的

如果采用微观消除筛查策略,在全球范围内消除丙型肝炎将更具可行性。我们旨在对罗马尼亚某些次区域的特定高危人群进行丙型肝炎病毒(HCV)筛查,并将他们与抗病毒治疗联系起来。

方法

2019年3月至2020年3月期间,在罗马尼亚4个城市(布加勒斯特、雅西、蒂米什瓦拉、克卢日-纳波卡)的20多家医疗机构中,对住院或门诊成年患者进行了一项多中心前瞻性研究。对所有入院患者进行了HCV诊断的快速诊断检测,阳性患者被送往胃肠病科以确认活动性感染、分期并开具治疗处方。

结果

共有25141名受试者签署了知情同意书并因此纳入研究。抗-HCV抗体的患病率为1.39%(95%CI:1.25-1.54),且随着受试者呈现的危险因素数量增加而升高。抗-HCV抗体的存在与女性性别(p<0.001)、农村居住地区(p<0.001)、高龄(p<0.001)呈正相关,与教育水平呈负相关(p<0.001)。

结论

在罗马尼亚一项基于医院的筛查微观消除项目中,HCV患病率低于先前报告。这是朝着在明确界定的高危人群中进行具有成本效益的筛查迈出的第一步,并为罗马尼亚提供了足够的能力来提供HCV治疗和护理联系。

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