在美国三个安全网医疗系统中,慢性乙型肝炎患者的肝炎三角病毒检测和患病率
Robert J Wong1, Mamta K Jain2, Bolin Niu3
1Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, California; Gastroenterology Section Veterans Affairs Palo Alto Healthcare System, Palo Alto, California.
概括
肝炎三角病毒 (HDV) 检测在患有慢性乙型肝炎 (CHB) 的安全网患者中很低,尽管风险很高. 在接受测试的人中,15.7%呈阳性,这凸显了改善HV查和随访的必要性.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 肝炎三角病毒 (HDV) 感染带来风险,特别是在患有慢性乙型肝炎 (CHB) 的安全网人口中.
- 关于这些易受伤害的群体中HV检测实践和流行率的数据有限.
- 安全网患者往往具有高 HDV 风险因素的高负担.
研究的目的:
- 为了评估HDV测试率和流行率在多样化,多中心队列的CHB.诊断的安全网患者.
- 在这个人群中确定HDV测试和抗HDV阳性的预测因素.
主要方法:
- 在美国3个安全网卫生系统 (2010-2022) 中对13,218名CHB患者进行了回顾性分析.
- 对HV测试的比例和测试者中阳性的比例的评估.
- 多变量后勤回归用于识别HVD测试和抗HDV阳性性的预测因素.
主要成果:
- 总体HDV检测率为6.1%,只有4.9%符合AASLD标准.
- 在男性,亚洲人和黑人/非洲裔美国人以及那些有医疗保险/医疗补助的人群中观察到更高的测试几率.
- 检测到的CHB患者中有15.7%是抗HDV阳性 (22.9%符合AASLD标准);只有2人进行了随访RNA测试.
- 较高的抗HDV阳性与基线肝硬化和医疗保险相关.
结论:
- 在多样化的安全网CHB队列中,即使有风险因素,也发现了低水平的HDV测试率.
- 很大一部分 (15.7%) 检测出HDV阳性,后续检测很少.
- 提高意识,教育和宣传对于提高HVD测试和安全网设置中的管理至关重要.
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