HCV Prevalence in Asian Americans in California
HCV Prevalence in Asian Americans in California
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DOI：
10.1007/s10903-016-0342-1
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发表时间：
2017-02-01
影响因子：
1.9
通讯作者：
Nguyen, Mindie H.
中科院分区：
文献类型：
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作者：
Lin, Oliver N.;Chang, Christine;Nguyen, Mindie H.
世界卫生组织估计，全世界有1.7亿人感染了丙型肝炎病毒，但只有2200万来自美洲和欧洲，而亚洲有9400万。HCV在美国总人口中的患病率为1.6%，但亚裔美国人的数据有限。我们的目的是研究在北加州一家免费诊所寻求初级保健的亚裔美国人的HCV患病率。2009年9月至2012年10月共连续收治1347例患者，采用病例报告表格进行个体图表复习。HCV感染定义为HCV抗体（抗-HCV）阳性或HCV RNA阳性。1347名患者中有699人接受了HCV筛查。亚裔美国人占这些患者的57.2%，29例（4.1%）HCV检测呈阳性。在这29例hcv阳性患者中，22例（75.9%）为亚洲人，亚洲人的患病率为5.5%，非亚洲人的患病率为2.3% （P = 0.038）。越南患者的HCV患病率最高，为7.9%，中国患者为6.0%。在hcv阳性的亚洲人中，没有人有静脉注射吸毒（IVDU）、纹身或性暴露史。在多变量分析中，HCV阳性感染的显著独立预测因子为男性（OR 2.53, P = 0.02）和存在已知危险因素（OR 21.1, P < 0.001）。然而，年龄和亚洲种族是HCV感染的显著预测因子（OR分别为1.03,P = 0.05和2.31,P = 0.066）。在我们的研究中，寻求常规初级保健的亚裔美国人的HCV患病率为5.5%，是非亚洲人的两倍多（2.3%）。已知的危险因素在亚洲HCV感染患者中也明显缺失。HCV在亚裔美国人中的高患病率可能反映了HCV在亚洲原籍国的高患病率。来自HCV流行国家的亚裔美国移民感染HCV的风险较高，无论其暴露风险如何，都应进行HCV筛查。
The World Health Organization estimates that 170 million persons are infected with HCV worldwide, but only 22 million are from the Americas and Europe, compared to 94 million from Asia. HCV prevalence in the general US population is 1.6 %, but data for Asian Americans are limited. Our goal was to examine HCV prevalence in Asian Americans in a large ethnically diverse patient cohort seeking primary care at a free clinic in Northern California. A total of 1347 consecutive patients were seen from September 2009 to October 2012 and were studied via individual chart review using case report forms. HCV infection was defined as positive HCV antibody (anti-HCV) or HCV RNA by PCR. 699 out of 1347 patients were screened for HCV. Asian Americans comprised 57.2 % of these patients and 29 (4.1 %) patients tested positive for HCV. Of these 29 HCV-positive patients, 22 (75.9 %) were Asian, yielding a prevalence of 5.5 % for Asians and 2.3 % for non-Asians (P = 0.038). The highest HCV prevalence was seen in Vietnamese patients at 7.9 %, and 6.0 % in Chinese patients. Of the HCV-positive Asians, none had a history of intravenous drug use (IVDU), tattoos, or sexual exposure. On multivariate analysis, significant independent predictors for positive HCV infection were male gender (OR 2.53, P = 0.02) and presence of known risk factors (OR 21.1, P < 0.001). However, older age and Asian ethnicity were found to be significant predictors of HCV infection (OR 1.03, P = 0.05 and 2.31, P = 0.066, respectively). In our study, HCV prevalence in patients seeking routine primary care was 5.5 % in Asian Americans, which was over double the prevalence for non-Asians at 2.3 %. Known risk factors were also notably absent in Asian patients with HCV infection. The high prevalence of HCV in Asian-Americans is likely reflective of the higher prevalence of HCV in their countries of origin in Asia. Asian-Americans immigrants from endemic countries are at higher risk of HCV infection and should be screened for HCV, regardless of their exposure risk profile.