在德国基层医疗机构的健康体检中成功筛查乙型肝炎和丙型肝炎

IF 9.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY JHEP Reports Pub Date : 2024-05-24 DOI:10.1016/j.jhepr.2024.101122
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引用次数: 0

摘要

背景& 目标世界卫生组织全球肝炎战略的目标是到 2030 年消除慢性丙型肝炎病毒 (HCV) 感染。作为该战略的一部分,联邦联合委员会(德国)决定将乙型肝炎和丙型肝炎筛查纳入预防性体检,该体检在德国的初级医疗机构进行。我们对 2021 年 10 月至 2022 年 9 月实施筛查 1 年后的结果进行了调查。方法根据 11 家非住院医疗中心 286192 人的账单类别确定了乙肝/丙肝 DNA 和抗-HCV/HCV RNA 筛查。结果与 2018 年的 30106 份 HBsAg 和 31266 份抗-HCV 实验室申请单相比,筛查期间的检测次数增加到 286192 次。与常规护理相比,额外的抗-HCV 阳性检测结果与年龄有关,在 35-44 岁人群中增加了 98%(男性 177 例加 170 例阳性病例)和 123%(女性 96 例加 118 例阳性病例),在 75-84 岁人群中增加了 518%(男性 17 例加 88 例阳性病例)和 514%(女性 29 例加 149 例阳性病例)。在 HBsAg 方面也观察到类似的结果。HBsAg、抗-HCV 和 HCV RNA 的患病率分别为 0.54%、0.79% 和 0.13%。影响和意义消除慢性乙型肝炎和丙型肝炎病毒感染的策略因国家而异,也因临床情况而异。我们的分析证明,在一个发病率较低的国家,与常规护理相比,由初级保健医生实施的筛查计划非常有效。在实施该计划的同时,还应在注射吸毒者等高危人群中开展更多工作,因为在目前的筛查方法中,注射吸毒者的比例较低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Successful hepatitis B and C screening in the health check-up in the German primary care setting

Background & Aims

A goal of the World Health Organization’s global hepatitis strategy is the elimination of chronic hepatitis C virus (HCV) infection by 2030. As part of its strategy, the Federal Joint Committee (Germany) decided to include hepatitis B and C screening in a preventive medical examination, which is performed at the primary care level in Germany. We investigated the results 1 year after implementation of screening between October 2021 and September 2022.

Methods

HBsAg/HBV DNA and anti-HCV/HCV RNA screenings were identified by billing categories in 286,192 individuals of 11 ambulatory healthcare centers.

Results

Compared to 30,106 HBsAg and 31,266 anti-HCV laboratory requisitions in the year 2018, the number of tests increased to 286,192 during the screening period. Compared to routine care, additional anti-HCV positive tests age dependently increased the tally by 98% (177 plus 170 positive cases in males) and 123% (96 plus 118 positive cases in females) in those aged 35-44 years up to 518% (17 plus 88 positive cases in males) and 514% (29 plus 149 positive cases in females) in those aged 75-84 years. Similar results were observed for HBsAg. Prevalences of HBsAg, anti-HCV and HCV RNA were 0.54%, 0.79% and 0.13%, respectively.

Conclusions

A structured hepatitis screening program at the primary care level has been successfully established and leads to age- and-sex-dependent large additional effects compared to routine care.

Impact and implications

Strategies to eliminate chronic hepatitis B and C virus infection are country specific and vary between clinical scenarios. Our analysis proves the efficacy of a screening program by primary care physicians compared to routine care in a low-prevalence country. This program should be accompanied by additional efforts in risk populations like people who inject drugs who are under-represented in the current screening approach.

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来源期刊
JHEP Reports
JHEP Reports GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
12.40
自引率
2.40%
发文量
161
审稿时长
36 days
期刊介绍: JHEP Reports is an open access journal that is affiliated with the European Association for the Study of the Liver (EASL). It serves as a companion journal to the highly respected Journal of Hepatology. The primary objective of JHEP Reports is to publish original papers and reviews that contribute to the advancement of knowledge in the field of liver diseases. The journal covers a wide range of topics, including basic, translational, and clinical research. It also focuses on global issues in hepatology, with particular emphasis on areas such as clinical trials, novel diagnostics, precision medicine and therapeutics, cancer research, cellular and molecular studies, artificial intelligence, microbiome research, epidemiology, and cutting-edge technologies. In summary, JHEP Reports is dedicated to promoting scientific discoveries and innovations in liver diseases through the publication of high-quality research papers and reviews covering various aspects of hepatology.
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Contents Editorial Board page Copyright and information Contents ALT levels, alcohol use, and metabolic risk factors have prognostic relevance for liver-related outcomes in the general population
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