法国住院患者普遍进行HCV查:这可能是一个很好的选择! 在DEVICHO研究
Si Ahmed Si Nafa1, Souad Benali1, Guillaume Penaranda2
1Department of Hepato-Gastroenterology, Hospital Saint Joseph, Marseille, France.
Journal of viral hepatitis
|May 21, 2025
概括
法国医院对型肝炎病毒 (HCV) 的普遍查比例行查更有效和更具成本效益,尽管初始成本更高. 这种方法可以识别更多的感染和治疗方法,这对公共卫生有好处.
科学领域:
- 肝病学和传染病的研究
- 公共卫生和流行病学
- 卫生经济学 卫生经济学
背景情况:
- 在法国,乙型肝炎病毒 (HCV) 感染的治疗是可以获得的,但查依赖于危险因素,使普遍查受到争议.
- 住院患者代表了一群人群,其HCV患病率可能比一般人群更高.
- 在医院环境中评估普遍查的成本效益对于优化公共卫生战略至关重要.
研究的目的:
- 评估法国住院患者普遍HCV查的有效性和成本效益.
- 为了确定这种特定患者队列中HCV感染的流行率.
- 将普遍查与传统的基于风险的查方法进行比较.
主要方法:
- 从2019年11月到2021年11月,在22个医院部门进行了前性DEVICHO研究.
- 为所有住院患者提供HCV的普遍查,数据与研究之外查的患者相比较.
- 分析包括HCV抗体 (HCV-Ab) 和RNA阳性,治疗率,持续的病毒学反应和成本效益计算.
主要成果:
- 共有25663名患者被邀请参加,其中19.4% (第一组) 参与了普遍查,而7% (第二组) 参与了例行查.
- 艾滋病毒-Ab阳性为2.9% (199/6789),其中14.6% (29/199) 是艾滋病毒-RNA阳性 (病毒性).
- 普遍查比例行查更有效和更具成本效益 (每次RNA感染11060欧元,每次治疗36600欧元),尽管前期成本更高.
结论:
- 基于医院的普遍HCV查是高效的,与一般人群相比,识别感染的流行率更高.
- 该战略具有成本效益,每种确诊的感染和治疗的成本低于法国人均GDP.
- 医疗保健专业人员的参与和改善与护理的联系是成功实施的关键障碍.
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