Medical School of Ningbo University, Ningbo University, Ningbo 315211, China.
Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China.
Int J Environ Res Public Health. 2022 Nov 25;19(23):15677. doi: 10.3390/ijerph192315677.
People who use drugs (PWUD) are among those with the highest risk for hepatitis C virus (HCV) infection. Highly effective direct-acting antiviral agents offer an opportunity to eliminate HCV. A simple tool for the prediction of HCV infection risk in PWUD is urgently needed. This study aimed to develop and validate a risk prediction tool to identify people at greater risk of having hepatitis C among PWUD that is applicable in resource-limited settings.
We extracted data from national HIV/AIDS sentinel surveillance in PWUD (Zhejiang Province, 2016-2021) and developed and validated a risk score to improve HCV testing in PWUD. This risk score consists of seven risk factors identified using multivariable logistic regression modeling (2016-2020, exploratory group). We validated this score using surveillance data for 2021 (validation group). The accuracy of the model was determined using C-statistics.
We identified seven risk factors, including sex, age, marital status, educational attainment, and the use of heroin, morphine, and methamphetamine. In the exploratory group, the positive rates of detecting the HCV antibody in the low-risk (0-9 points), intermediate-risk (10-16 points), and high-risk (≥17 points) groups were 6.72%, 17.24%, and 38.02%, respectively ( < 0.001). In the validation group, the positive rates in the low-, medium-, and high-risk groups were 4.46%, 12.23%, and 38.99%, respectively ( < 0.001).
We developed and validated a drug-specific risk prediction tool for identifying PWUD at increased risk of HCV infection. This tool can complement and integrate the screening strategy for the purpose of early diagnosis and treatment.
吸毒人群（PWUD）是丙型肝炎病毒（HCV）感染风险最高的人群之一。高效的直接作用抗病毒药物为消除 HCV 提供了机会。因此，迫切需要一种用于预测 PWUD 中 HCV 感染风险的简单工具。本研究旨在开发和验证一种风险预测工具，以识别 PWUD 中具有更高 HCV 感染风险的人群，该工具适用于资源有限的环境。
我们从全国 HIV/AIDS 哨点监测中提取了 PWUD（浙江省，2016-2021 年）的数据，并开发和验证了一种风险评分，以提高 PWUD 中的 HCV 检测率。该风险评分由通过多变量逻辑回归建模确定的七个风险因素组成（2016-2020 年，探索性组）。我们使用 2021 年的监测数据对该评分进行了验证（验证组）。使用 C 统计量确定模型的准确性。
我们确定了七个风险因素，包括性别、年龄、婚姻状况、受教育程度以及海洛因、吗啡和甲基苯丙胺的使用。在探索性组中，低风险（0-9 分）、中风险（10-16 分）和高风险（≥17 分）组 HCV 抗体检测的阳性率分别为 6.72%、17.24%和 38.02%（<0.001）。在验证组中，低、中、高风险组的阳性率分别为 4.46%、12.23%和 38.99%（<0.001）。
我们开发并验证了一种针对特定药物的风险预测工具，用于识别 HCV 感染风险增加的 PWUD。该工具可以补充和整合筛查策略，以实现早期诊断和治疗。
