Comparison of Risk-Based Hepatitis C Screening and the True Seroprevalence in an Urban Prison System
Comparison of Risk-Based Hepatitis C Screening and the True Seroprevalence in an Urban Prison System
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DOI：
10.1007/s11524-015-9945-4
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发表时间：
2015-04-01
影响因子：
6.6
通讯作者：
Viner, Kendra M.
中科院分区：
文献类型：
--
作者：
Kuncio, Danica E.;Newbern, E. Claire;Viner, Kendra M.
丙型肝炎病毒（HCV）是美国最常见的血源性感染，尽管在某些高危人群（如囚犯）中血清阳性率升高。惩教设施筛查方案从普遍检测到基于风险的选择性检测各不相同。该项目通过比较2011-2012年（基于风险的筛查组）和2012年9月的一项盲法血清患病率研究（费城公共卫生部（PDPH）研究队列）的结果，评估了费城监狱系统（PPS）基于风险的HCV筛查策略的成功。2011-2012年，缴费灵处理了51,562名囚犯；2727人被确定为高危人群并接受了HCV筛查，其中57%的人HCV抗体检测呈阳性。在PDPH研究队列中的1289名囚犯中，12% （n = 154）是抗hcv阳性。每千分之一到30岁的囚犯在两组中血清阳性率都更高。由于只有5.3%的监狱人口被纳入基于风险的筛查组，预计2011-2012年还有4,877名丙型肝炎病毒阳性囚犯未被发现。当PPS利用基于风险的检测时，在病例识别方面存在差距。应该考虑采用一种更全面的筛查模式，如选择退出的普遍检测，以识别丙型肝炎病毒阳性的囚犯。识别这些人是一个重要的机会，可以帮助服务不足的高危人群，并提供医疗保健和二级预防。
Hepatitis C virus (HCV) is the most common blood-borne infection in the USA, though seroprevalence is elevated in certain high-risk groups such as inmates. Correctional facility screening protocols vary from universal testing to opt-in risk-based testing. This project assessed the success of a risk-based HCV screening strategy in the Philadelphia Prison System (PPS) by comparing results from current testing practices during 2011-2012 (Risk-Based Screening Group) to a September 2012 blinded seroprevalence study (Philadelphia Department of Public Health (PDPH) Study Cohort). PPS processed 51,562 inmates in 2011-2012; 2,727 were identified as high-risk and screened for HCV, of whom 57 % tested HCV antibody positive. Twelve percent (n = 154) of the 1,289 inmates in the PDPH Study Cohort were anti-HCV positive. Inmates a parts per thousand yen30 years of age had higher rates of seropositivity in both groups. Since only 5.3 % of the prison population was included in the Risk-Based Screening Group, an additional 4,877 HCV-positive inmates are projected to have not been identified in 2011-2012. Gaps in case identification exist when risk-based testing is utilized by PPS. A more comprehensive screening model such as opt-out universal testing should be considered to identify HCV-positive inmates. Identification of these individuals is an important opportunity to aid underserved high-risk populations and to provide medical care and secondary prevention.