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美国黑人肝炎:一篇综述
Oluwaseun Falade-Nwulia1, Sharon M Kelly1, Sasraku Amanor-Boadu2
1Division of Infectious Diseases, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
JAMA
|November 9, 2023
概括
乙型肝炎病毒 (HCV) 对黑人影响不成比例,黑人也是诊断病例增长率最高的人群. 照顾点检测和患者导航等策略可以提高HCV诊断和治疗率.
科学领域:
- 公共卫生
- 传染性疾病
- 健康上的差异
背景情况:
- 与其他种族群体相比,美国黑人群体中C型肝炎病毒 (HCV) 的流行率和死亡率较高.
- 在2015年至2021年期间,黑人感染HCV的比例增长最为显著.
研究的目的:
- 研究美国不同种族群体中HCV流行,发病率和治疗开始的差异.
- 确定提高HCV查,诊断和治疗的有效策略,特别是针对黑人群体.
主要方法:
- 根据种族分层的HCV流行,死亡和发病率数据的分析.
- 在有医疗补助保险的黑人和白人中对治疗开始率的审查.
- 评估干预措施,包括电子病历提示,临床检测,患者导航和消除治疗限制.
主要成果:
- 与非黑人群体相比,黑人群体的HCV患病率 (1.8%) 和死亡率 (5.01/100,000) 较高.
- 从2015年到2021年,黑人感染HCV的比例增加了367%.
- 临床检测提高了检测结果的认识 (69%对19%),患者导航改善了护理和治疗的开始.
- 消除治疗限制显著增加了HCV治疗率,而没有显著的种族差异.
结论:
- 黑人社区受到HCV的影响不成比例,
- 改善HCV结局的关键是医疗点检测,患者导航和不受限制的治疗.
- 解决系统性障碍,如治疗限制,对于公平的HCV护理至关重要.
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