在实现丙型肝炎病毒微量清除方面，医院筛查优于初级保健筛查。

IF 2.9 4区医学 Q2 INFECTIOUS DISEASES Infectious diseases now Pub Date : 2024-02-02 DOI:10.1016/j.idnow.2024.104855

Carlos E. Fernández-García , Juan Gallego-Galiana , Pablo A. Solís-Muñoz , Elvira del Pozo-Maroto , Lucía Domínguez-Alcón , Milagros Tobar-Izquierdo , Alicia Sáez , Javier Rodríguez de Cía , Amelia Magaña-Sánchez , Yolanda Real-Martínez , Luisa García-Buey , Leticia González-Moreno , María Caldas-Álvarez , Laura M. Cardeñoso-Domingo , Amelia González-Gamarra , Antonio Salvador-Calvo , Águeda González-Rodríguez , Carmelo García-Monzón

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摘要

目的：评估医院HCV筛查项目和基层医疗中心HCV筛查模式各自的效果：方法：对连续入院接受非卧床手术的成人患者进行抗-HCV抗体筛查（医院筛查队列，HPSC），同时对因医疗原因在初级医疗中心接受血液检测的患者进行筛查（初级医疗筛查队列，PCSC）。血清抗-HCV和HCV RNA水平分别通过ELISA和实时PCR进行检测：结果：HPSC 中的 HCV 血清感染率为 2.2%，PCSC 中为 1.4%（P=0.044）。所有病毒血症患者（HPSC为0.2%，PCSC为0.1%）均接受了直接作用抗病毒药物治疗，85.7%的患者获得了持续病毒学应答：医院HCV筛查的效果优于以初级保健为中心的筛查，大大增加了HCV病例的发现率。

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Hospital-based screening outperforms primary care screening as a means of achieving hepatitis C virus micro-elimination

Aim

To assess the respective performances of a HCV screening program in a hospital setting and a HCV screening model applied concomitantly in a primary care centre.

Methods

Adult patients consecutively admitted to hospital for ambulatory surgery were screened for anti-HCV antibodies (hospital screening cohort, HPSC), as were patients receiving blood tests for medical reasons in a primary care centre (primary care screening cohort, PCSC). Serum anti-HCV and HCV RNA levels were tested by ELISA and real-time PCR, respectively.

Results

Seroprevalence of HCV infection was 2.2 % in the HPSC and 1.4 % in the PCSC (p = 0.044). All viraemic patients (0.2 % in HPSC and 0.1 % in PCSC) were treated with direct-acting antivirals and 85.7 % experienced a sustained virological response.