Disease Elimination Program, Burnet Institute, Melbourne, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Epidemiol Infect. 2021 Dec 6;150:e7. doi: 10.1017/S0950268821002624.
To achieve the elimination of the hepatitis C virus (HCV), sustained and sufficient levels of HCV testing is critical. The purpose of this study was to assess trends in testing and evaluate the effectiveness of strategies to diagnose people living with HCV. Data were from 12 primary care clinics in Victoria, Australia, that provide targeted services to people who inject drugs (PWID), alongside general health care. This ecological study spanned 2009-2019 and included analyses of trends in annual numbers of HCV antibody tests among individuals with no previous positive HCV antibody test recorded and annual test yield (positive HCV antibody tests/all HCV antibody tests). Generalised linear models estimated the association between count outcomes (HCV antibody tests and positive HCV antibody tests) and time, and χ2 test assessed the trend in test yield. A total of 44 889 HCV antibody tests were conducted 2009-2019; test numbers increased 6% annually on average [95% confidence interval (CI) 4-9]. Test yield declined from 2009 (21%) to 2019 (9%) (χ2P = <0.01). In more recent years (2013-2019) annual test yield remained relatively stable. Modest increases in HCV antibody testing and stable but high test yield within clinics delivering services to PWID highlights testing strategies are resulting in people are being diagnosed however further increases in the testing of people at risk of HCV or living with HCV may be needed to reach Australia's HCV elimination goals.
为实现丙型肝炎病毒（HCV）的消除，持续且充分的 HCV 检测水平至关重要。本研究旨在评估检测趋势并评估诊断 HCV 感染者的策略的有效性。数据来自澳大利亚维多利亚州的 12 个初级保健诊所，这些诊所为注射毒品者（PWID）提供针对性服务，并提供一般医疗服务。这项生态研究跨越 2009-2019 年，包括分析无既往 HCV 抗体阳性检测记录的个体的年度 HCV 抗体检测数量和年度检测收益（阳性 HCV 抗体检测/所有 HCV 抗体检测）的趋势。广义线性模型估计了计数结果（HCV 抗体检测和阳性 HCV 抗体检测）与时间之间的关联，χ2 检验评估了检测收益的趋势。2009-2019 年共进行了 44889 次 HCV 抗体检测；检测数量平均每年增加 6%[95%置信区间（CI）为 4-9]。检测收益从 2009 年（21%）下降到 2019 年（9%）（χ2 P <0.01）。在最近几年（2013-2019 年），年度检测收益保持相对稳定。向 PWID 提供服务的诊所中 HCV 抗体检测适度增加，检测收益稳定但仍很高，这表明检测策略正在导致人们被诊断出 HCV，但可能需要进一步增加 HCV 风险人群或 HCV 感染者的检测，以实现澳大利亚的 HCV 消除目标。
