Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
J Viral Hepat. 2024 Nov;31(11):657-669. doi: 10.1111/jvh.13985. Epub 2024 Jul 30.
In 2023, the US Centers for Disease Control and Prevention recommended universal screening for hepatitis B virus (HBV); however, the proportion of US adults screened before implementing this recommendation is unknown. We analysed nationally representative data from the National Health Interview Survey (2013-2017) on self-reported HBV testing among noninstitutionalized US adults ≥18 years. We employed Poisson logistic regression to identify factors associated with self-reported testing, using a conceptual framework that included four overarching factors: sociodemographic characteristics, healthcare access, health-seeking behaviours and experiences, and access to internet-based health information. Among 149,628 survey respondents, the self-reported HBV testing rate was 27.2% (95% CI 26.2-28.7) and increased by 1.7% from 2013 to 2017 (p = .006). In adjusted analysis, health-seeking behaviours and experiences had the strongest associations of self-reported testing including a history of hepatitis (AOR 2.68, 95% CI 1.92-3.73), receipt of hepatitis B vaccination (AOR 5.11, 95% CI 4.61-5.68) and prior testing for hepatitis C (AOR 9.14, 95% CI 7.97-10.48) and HIV (AOR 2.69, 95% CI 2.44-2.97). Other factors associated with testing included being male (AOR 1.14, 95% CI 1.03-1.26), ages 30-44 years (AOR 1.37, 95% CI 1.17-1.61), 45-60 years (AOR 1.55, 95% CI 1.30-1.80) and ≥60 years (AOR 1.53, 95% CI 1.28-1.84), residence in the Western US region (AOR 1.23, 95% CI 1.06-1.43), and access to internet-based health information (AOR 1.32, 95% CI 1.18-1.47). Being Hispanic was associated with lower odds of testing (AOR 0.80, 95% CI 0.66-0.97). These findings may help guide optimal HBV screening in the universal testing era.
2023 年，美国疾病控制与预防中心建议对乙型肝炎病毒（HBV）进行普遍筛查；然而，在实施这一建议之前，接受筛查的美国成年人的比例尚不清楚。我们分析了全国代表性数据，这些数据来自 2013 年至 2017 年期间全国健康访谈调查（National Health Interview Survey）中自我报告的非住院美国成年人（年龄≥18 岁）HBV 检测情况。我们采用泊松逻辑回归分析方法，使用包括四个总体因素的概念框架，对自我报告的检测相关因素进行分析：社会人口统计学特征、医疗保健可及性、寻求医疗保健行为和经历，以及互联网健康信息的获取。在 149628 名调查对象中，自我报告的 HBV 检测率为 27.2%（95%CI 26.2-28.7），2013 年至 2017 年期间，该检测率增加了 1.7%（p=0.006）。在调整后的分析中，寻求医疗保健行为和经历与自我报告的检测结果具有最强的关联，包括肝炎病史（AOR 2.68，95%CI 1.92-3.73）、乙型肝炎疫苗接种（AOR 5.11，95%CI 4.61-5.68）、丙型肝炎（AOR 9.14，95%CI 7.97-10.48）和 HIV（AOR 2.69，95%CI 2.44-2.97）检测史。与检测相关的其他因素包括男性（AOR 1.14，95%CI 1.03-1.26）、30-44 岁（AOR 1.37，95%CI 1.17-1.61）、45-60 岁（AOR 1.55，95%CI 1.30-1.80）和≥60 岁（AOR 1.53，95%CI 1.28-1.84）、居住在美国西部（AOR 1.23，95%CI 1.06-1.43）、以及获取互联网健康信息（AOR 1.32，95%CI 1.18-1.47）。西班牙裔的检测几率较低（AOR 0.80，95%CI 0.66-0.97）。这些发现可能有助于指导普遍检测时代的最佳 HBV 筛查。
