型肝炎反射检测对未来疾病负担的影响:模型分析
Maria Buti1,2, Raquel Domínguez-Hernández3, Adriana Palom1,2
1Liver Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
概括
在西班牙实施D型肝炎反射检测可以显著提高HBsAg阳性个体慢性肝炎D (CHD) 的诊断和治疗. 预计到2030年,这一战略将使肝脏并发症和医疗保健成本减少35-38%.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒性肝炎病毒性肝炎
- 公共卫生 公共卫生
背景情况:
- 慢性肝炎D (CHD) 是一种严重的肝病,导致肝硬化和癌症.
- 心脏病经常被低诊断,特别是在HBsAg阳性个体中.
- 目前西班牙的乙型肝炎病毒 (HDV) 诊断率很低.
研究的目的:
- 评估在西班牙对HBsAg阳性个体实施D型肝炎反射检测的影响.
- 在8年的时间内评估反射检测的临床和经济效益.
- 在不同的测试场景下建模CHD护理级联.
主要方法:
- 使用决策树模型来模拟CHD护理级联.
- 两种情景进行了比较:当前的测试实践与对抗HDV的普遍反射测试.
- 该模型预测了包括诊断,治疗和并发症在内的结果.
主要成果:
- 据估计,反射检测将使抗HDV检测增加5498例,HDV-RNA检测增加3225例.
- 另外还有2128名患者将接受治疗,其中213人获得了无法检测的HDV-RNA.
- 预计肝脏并发症 (肝硬化,HCC,肝脏相关死亡) 将减少35-38%,估计节省3600万欧元.
结论:
- 实施抗HDV反射检测是改善西班牙心血管疾病诊断和管理的成本效益高的策略.
- 这种方法显著减少了CHD的临床负担和经济影响.
- 到2030年,广泛的反射检测可以大幅降低与心血管疾病相关的发病率和死亡率.
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