我们了解丙型肝炎感染吗？土耳其爱琴海地区三级参考资料中心的丙型肝炎病毒检测结果

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Clinical Practice Pub Date : 2024-08-13 DOI:10.1155/2024/8857910

Gözde Derviş Hakim, Pınar Şamlıoglu, Murat Aysin, Taner Kara, Şükran Köse

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引用次数: 0

摘要

背景。随着直接作用抗病毒药物的出现，治疗丙型肝炎病毒（HCV）感染的持续病毒学应答率已达到 100%。然而，据观察，许多患者仍无法获得治疗。研究目的本研究旨在确定抗-HCV 和 HCV-RNA 阳性的患者，揭示未确诊病例，从而揭示增加 HCV 跟踪检测和诊断的必要性。研究方法对特佩契克研究与培训医院微生物数据库中 2013 年 1 月至 2023 年 1 月期间接受抗-HCV 和 HCV-RNA 检测的患者进行研究。根据患者的输入日期对其进行索引，并人工去除重复值。然后根据要求进行分析的诊所对数据进行分组。分析结果在 2013 年至 2023 年期间，共进行了 334,537 次抗 HCV 检测，无重复检测。年平均检测次数为 33,454 ± 10,027 次。在这十年间，抗-HCV 检测结果呈阳性的患者总数为 3943 人。在所有抗-HCV 检测中，阳性率为 1.18%。检测结果呈阳性的年平均人数为 394 ± 54。2013 年至 2022 年间，在抗-HCV 检测呈阳性的 3943 名患者中，有 2500 人（63.4%）进行了 HCV-RNA 分析。在接受 HCV-RNA 分析的 2 500 名患者中，发现 682 人（27.4%）HCV-RNA 阳性，1 818 人（72.6%）HCV-RNA 阴性。在这十年中，根据内科和外科分支机构对 334,537 次抗 HCV 检测的分布情况进行评估后发现，157,680 次检测（47.1%）来自内科分支机构，而 176,857 次检测（52.9%）来自外科分支机构。在抗-HCV 检测呈阳性并接受 HCV-RNA 分析的 2,500 例患者中，2,273 例（90.9%）由内科分院申请，而外科分院申请了 227 例（9.1%）。在抗-HCV 检测呈阳性但未进行 HCV-RNA 检测的 1,443 名患者中，有 788 人（54.6%）在内科进行了评估，655 人（45.4%）在外科进行了评估。结论本研究发现，同一患者需要进行多次抗-HCV 检测，而对于抗-HCV 检测呈阳性的患者，并未要求进行 HCV-RNA 检测。此外，患者并未被转诊至感染科或消化科诊所进行 HCV-RNA 检测。因此，得出的结论是，没有进行充分和必要的诊断检测，导致患者无法获得治疗。为了实现世界卫生组织根除 HCV 的目标，当务之急是提高 HCV-RNA 检测率，加强反射检测的利用率，并确保适当转诊到必要的诊所。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Are We Aware of Hepatitis C Infection? HCV Results from the Tertiary Reference Center in the Aegean Region from Turkey

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Are We Aware of Hepatitis C Infection? HCV Results from the Tertiary Reference Center in the Aegean Region from Turkey

Background. With the advent of direct-acting antiviral agents, the rate of sustained virological response in the treatment of hepatitis C virus (HCV) infection has reached 100%. However, it has been observed that many patients still do not have access to treatment. Aim. The aim of this study was to identify patients who are anti-HCV and HCV-RNA-positive, to reveal undiagnosed cases, and thus to reveal the necessity of increasing HCV follow-up tests and diagnosis. Methods. The microbiology database of Tepecik Research and Training Hospital was examined for patients who were tested for anti-HCV and HCV-RNA from January 2013 to January 2023. Patients were indexed based on their entry date, and duplicate values were manually removed. The data were then grouped according to the clinics that requested the analysis. Results. Between 2013 and 2023, a total of 334,537 anti-HCV tests were conducted without duplications. The annual average number of tests was 33,454 ± 10,027. During the ten-year period under review, the total number of patients with a positive result for the anti-HCV test was 3,943. The positivity rate among all anti-HCV tests was 1.18%. The annual average number of positive test results was 394 ± 54. Between 2013 and 2022, out of the 3,943 patients who tested positive for anti-HCV, HCV-RNA analysis was conducted on 2,500 of them (63.4%). Among the 2,500 patients who underwent HCV-RNA analysis, 682 were found to be HCV-RNA-positive (27.4%), while 1,818 were HCV-RNA-negative (72.6%). In the ten-year period, when the distribution of the 334,537 anti-HCV tests according to internal and surgical branches was evaluated, it was found that 157,680 tests (47.1%) were requested from internal branches, while 176,857 tests (52.9%) were requested from surgical branches. Of the 2,500 patients who tested positive for anti-HCV and underwent HCV-RNA analysis, 2,273 (90.9%) were requested by internal branches, while surgical branches requested 227 tests (9.1%). Among the 1,443 patients who tested positive for anti-HCV but did not have HCV-RNA tests ordered, 788 (54.6%) were evaluated in internal branches, and 655 (45.4%) were evaluated in surgical branches. Conclusion. In this study, it was observed that multiple anti-HCV tests were requested for the same individual, and HCV-RNA tests were not ordered for those testing positive for anti-HCV. Moreover, patients were not referred to the infection or gastroenterology clinics for HCV-RNA testing. Consequently, it was concluded that sufficient and necessary tests for diagnosis were not conducted, leading to the inability to access treatment. To achieve the World Health Organization’s goals for HCV eradication, it is imperative to increase the rates of HCV-RNA testing, enhance the utilization of reflex testing, and ensure proper referral to the necessary clinics.

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来源期刊

International Journal of Clinical Practice 医学-医学：内科

CiteScore

5.30

自引率

0.00%

发文量

274

审稿时长

3-8 weeks

期刊介绍： IJCP is a general medical journal. IJCP gives special priority to work that has international appeal. IJCP publishes: Editorials. IJCP Editorials are commissioned. [Peer reviewed at the editor''s discretion] Perspectives. Most IJCP Perspectives are commissioned. Example. [Peer reviewed at the editor''s discretion] Study design and interpretation. Example. [Always peer reviewed] Original data from clinical investigations. In particular: Primary research papers from RCTs, observational studies, epidemiological studies; pre-specified sub-analyses; pooled analyses. [Always peer reviewed] Meta-analyses. [Always peer reviewed] Systematic reviews. From October 2009, special priority will be given to systematic reviews. [Always peer reviewed] Non-systematic/narrative reviews. From October 2009, reviews that are not systematic will be considered only if they include a discrete Methods section that must explicitly describe the authors'' approach. Special priority will, however, be given to systematic reviews. [Always peer reviewed] ''How to…'' papers. Example. [Always peer reviewed] Consensus statements. [Always peer reviewed] Short reports. [Always peer reviewed] Letters. [Peer reviewed at the editor''s discretion] International scope IJCP publishes work from investigators globally. Around 30% of IJCP articles list an author from the UK. Around 30% of IJCP articles list an author from the USA or Canada. Around 45% of IJCP articles list an author from a European country that is not the UK. Around 15% of articles published in IJCP list an author from a country in the Asia-Pacific region.