Medical Information Center, Kyushu University Hospital, Fukuoka city, 812-8582 Maidashi3-1-1 Higashi-ku, Fukuoka, Japan.
BMC Public Health. 2022 Apr 7;22(1):681. doi: 10.1186/s12889-022-13089-w.
We investigated the association between municipal socioeconomic deprivation levels and the positivity of hepatitis B surface antigen (HBsAg) and the prevalence of hepatitis C virus (HCV) among individuals who have never participated in hepatitis screening using Japanese national screening data.
The hepatitis virus screening data analyzed included the 5-year age group-specific number of participants aged 40 years or older, number of HBsAg-positive persons, and number of HCV carriers for each municipality from 2013 to 2017. Principal component analysis was used to derive a socioeconomic deprivation level using the socioeconomic characteristics of municipalities. Bayesian spatial Poisson regression analysis was conducted to investigate the association between the socioeconomic deprivation level and the results of screening. Data on 1,660 municipalities were used in the analysis.
The data of 4,233,819 participants in the HBV screening and 4,216,720 in the HCV screening were used in the analysis. A principal component interpreted as level of rurality (principal component 1) and another principal component interpreted as level of low socioeconomic status among individuals (principal component 2) were extracted as the major principal components. Their principal component scores were used as the deprivation levels of municipalities. Spatial regression analysis showed that the deprivation level derived from the sum of the scores of principal components 1 and 2 was significantly and positively associated with HBsAg positivity and HCV prevalence. In addition, the deprivation level derived only from the score of principal component 2 was also significantly and positively associated with the outcomes. Conversely, the deprivation level derived only from the score of principal component 1 was not associated with the outcomes. Moreover, population density was significantly and positively associated with HBsAg positivity and HCV prevalence.
This study suggested that participation in hepatitis virus screening is important and meaningful, particularly for areas with a higher lower socioeconomic level in Japan.
本研究利用日本全国性筛查数据，调查了城市社会经济剥夺水平与从未参与过肝炎筛查的个体乙型肝炎表面抗原（HBsAg）阳性率和丙型肝炎病毒（HCV）流行率之间的关系。
分析的肝炎病毒筛查数据包括 2013 年至 2017 年，每个市 40 岁及以上年龄组的参与者数量、HBsAg 阳性人数和 HCV 携带者人数。采用主成分分析法，根据城市的社会经济特征，得出社会经济剥夺水平。采用贝叶斯空间泊松回归分析，研究社会经济剥夺水平与筛查结果之间的关系。分析共使用了 1660 个市的数据。
HBV 筛查分析中使用了 4233819 名参与者的数据，HCV 筛查分析中使用了 4216720 名参与者的数据。提取出两个主要主成分，一个主成分解释为农村水平（主成分 1），另一个主成分解释为个体低社会经济地位水平（主成分 2）。将这两个主成分的得分作为城市的剥夺水平。空间回归分析显示，主成分 1 和 2 得分之和所代表的剥夺水平与 HBsAg 阳性率和 HCV 流行率显著正相关。此外，仅由主成分 2 得分代表的剥夺水平也与结果显著正相关。相反，仅由主成分 1 得分代表的剥夺水平与结果无关。此外，人口密度与 HBsAg 阳性率和 HCV 流行率呈显著正相关。
本研究表明，参与肝炎病毒筛查非常重要且有意义，特别是在日本社会经济水平较低的地区。
