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不能以年齡作為HCV篩查標(biāo)準(zhǔn)
2019-03-22 12:54
2013年美國(guó)胃腸病學(xué)會(huì)年度會(huì)議上發(fā)表的一項(xiàng)研究表明：僅以年齡作為HCV篩查的標(biāo)準(zhǔn)，在危險(xiǎn)分層基礎(chǔ)上的病例篩選中并非是非常有效的。
研究者們?cè)谖挥诩~約的兩所社區(qū)醫(yī)院對(duì)396名患者進(jìn)行了有關(guān)HCV感染危險(xiǎn)因素的問(wèn)卷調(diào)查，并且對(duì)其中160位年齡介于40到74歲的患者進(jìn)行了HCV的檢測(cè)，這些人之前從未進(jìn)行過(guò)這類(lèi)檢測(cè)。此外接受問(wèn)卷調(diào)查的患者中還包括45名愿意但并未進(jìn)行HCV檢測(cè)的個(gè)體，34名拒絕接受檢測(cè)的個(gè)體，157名已知HCV抗體陽(yáng)性個(gè)體以及85名之前HCV測(cè)試呈陽(yáng)性的患者。在經(jīng)過(guò)篩選的患者中，64.9%的人為非洲裔美國(guó)人，接近23.7%的人是西班牙裔。76%的患者擁有高中及以下的學(xué)歷水平。
在該研究中接受HCV篩查的160名患者中，僅有1例檢測(cè)為陽(yáng)性。研究者稱(chēng)該患者有一項(xiàng)HCV的危險(xiǎn)因素（多個(gè)性伴侶）。在接受調(diào)查的患者中，幾乎所有的HCV陽(yáng)性患者年齡均介于48至68歲，但是這些人也同時(shí)擁有HCV感染的一項(xiàng)或更多的危險(xiǎn)因素。篩選的患者中有接近一半（50.9%）的人檢測(cè)為HCV陽(yáng)性并且并不了解該病的相關(guān)危險(xiǎn)因素，而其中1.1%的陽(yáng)性患者并未發(fā)現(xiàn)危險(xiǎn)因素。
“不能以年齡作為HCV篩查標(biāo)準(zhǔn)，”紐約跨信仰醫(yī)療中心的Ayotokunbo Olosunde （MD）向Healio.com網(wǎng)說(shuō)。“這是一項(xiàng)小規(guī)模的研究，但是它卻向我們表明了：如果要確認(rèn)一例HCV陽(yáng)性病例的話(huà)，需要我們做出許多檢測(cè)。”[出生隊(duì)列篩選]僅供參考，但是在發(fā)現(xiàn)陽(yáng)性病例之前你不得不做出面對(duì)許多例陰性的檢測(cè)，對(duì)此你要有心理準(zhǔn)備。我們不能舍棄危險(xiǎn)分層基礎(chǔ)上的病例篩選，相反我們要將各種方法結(jié)合起來(lái)。
“[出生隊(duì)列篩選]并不會(huì)否認(rèn)我們1998年制定的指南，即有危險(xiǎn)因素的個(gè)體有必要接受篩查，”跨宗教醫(yī)療中心的Gopal Kaza（MD）說(shuō)道。“這一點(diǎn)要優(yōu)先于基于年齡分層的篩選。一旦某人有了該病的危險(xiǎn)因素，那么就可以對(duì)其進(jìn)行篩查。這樣我們得到陽(yáng)性結(jié)果的概率要高于只是說(shuō)一句‘鑒于你出生在1945-1965年間，請(qǐng)接收HCV的篩查。’”
A study published at the 2013 annual meeting of the American Gastroenterology Society showed that using age alone as a criterion for HCV screening is not very effective in screening cases based on risk stratification.
The researchers surveyed 396 patients at two New York community hospitals about their risk factors for HCV infection and tested 160 of them, aged 40 to 74, who had never been tested before. In addition, the patients who received the questionnaire also included 45 individuals who were willing but not tested for HCV, 34 individuals who refused to be tested, 157 known HCV positive individuals, and 85 patients who had previously tested positive for HCV. Among the screened patients, 64.9 % were African Americans and nearly 23.7 % were Hispanic. 76 % of patients have a high school education level or below.
Of the 160 patients screened for HCV in the study, only one tested positive. The researchers said the patient had a risk factor for HCV(multiple sexual partners). Almost all of the patients surveyed were between 48 and 68 years of age, but these people also had one or more risk factors for HCV infection. Nearly half(50.9 %) of the patients screened tested positive for HCV and did not understand the risk factors related to the disease, while 1.1 % of the positive patients did not find risk factors.
"Age can not be used as a standard for HCV screening," Ayotokunbo Olosunde(MD), of the Interfaith Medical Center in New York, told Healio.com. "This is a small study, but it shows us that if we want to confirm a positive HCV case, we need to do a lot of tests. "[ Birth queue filter] For reference only, but you have to prepare for a number of negative tests before you find a positive case. We can not discard risk stratification as a basis for case screening. Instead, we need to combine various methods.
"[ Birth queue filter] There is no denying the guidelines we developed in 1998 that individuals with risk factors need to be screened, "said Gopal Kaza(MD) of the Interreligious Medical Center. "This takes precedence over screening based on age stratification. Once a person has a risk factor for the disease, they can be screened. In this way, we are more likely to get positive results than just saying, 'Since you were born between 1945 and 1965, please receive HCV screening. ' "
A study published at the 2013 annual meeting of the American Gastroenterology Society showed that using age alone as a criterion for HCV screening is not very effective in screening cases based on risk stratification.
The researchers surveyed 396 patients at two New York community hospitals about their risk factors for HCV infection and tested 160 of them, aged 40 to 74, who had never been tested before. In addition, the patients who received the questionnaire also included 45 individuals who were willing but not tested for HCV, 34 individuals who refused to be tested, 157 known HCV positive individuals, and 85 patients who had previously tested positive for HCV. Among the screened patients, 64.9 % were African Americans and nearly 23.7 % were Hispanic. 76 % of patients have a high school education level or below.
Of the 160 patients screened for HCV in the study, only one tested positive. The researchers said the patient had a risk factor for HCV(multiple sexual partners). Almost all of the patients surveyed were between 48 and 68 years of age, but these people also had one or more risk factors for HCV infection. Nearly half(50.9 %) of the patients screened tested positive for HCV and did not understand the risk factors related to the disease, while 1.1 % of the positive patients did not find risk factors.
"Age can not be used as a standard for HCV screening," Ayotokunbo Olosunde(MD), of the Interfaith Medical Center in New York, told Healio.com. "This is a small study, but it shows us that if we want to confirm a positive HCV case, we need to do a lot of tests. "[ Birth queue filter] For reference only, but you have to prepare for a number of negative tests before you find a positive case. We can not discard risk stratification as a basis for case screening. Instead, we need to combine various methods.
"[ Birth queue filter] There is no denying the guidelines we developed in 1998 that individuals with risk factors need to be screened, "said Gopal Kaza(MD) of the Interreligious Medical Center. "This takes precedence over screening based on age stratification. Once a person has a risk factor for the disease, they can be screened. In this way, we are more likely to get positive results than just saying, 'Since you were born between 1945 and 1965, please receive HCV screening. ' "
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