Prevalence of Hepatitis C Virus Infection Identified From Nontargeted Screening Among Adult Visitors in an Academic Appalachian Regional Emergency Department.
Prevalence of Hepatitis C Virus Infection Identified From Nontargeted Screening Among Adult Visitors in an Academic Appalachian Regional Emergency Department.
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DOI：
10.1093/ofid/ofab374
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发表时间：
2021-08
影响因子：
4.2
通讯作者：
Havens JR
中科院分区：
文献类型：
--
作者：
Daniel Moore J;Galbraith J;Humphries R;Havens JR
我们描述了成人学术急诊科（艾德）非靶向丙型肝炎病毒（HCV）筛查计划的初步结果，该计划服务于阿巴拉契亚，受阿片类药物流行的影响不成比例。该研究是一项回顾性筛查研究，研究了2018年7月至2020年9月期间艾德系统性、非靶向、选择退出的HCV检测结果。“非靶向”HCV检测的资格要求包括年龄≥18岁，能够口头交流，接受血液检查已经作为常规临床护理的一部分，并且不选择退出检测。对于没有选择退出测试的合格个体，进行HCV抗体（Ab）测试。反应性抗体检测通过反射性HCV RNA检测得到证实。主要研究结果是HCV抗体和RNA患病率的特征。在研究期间，有75722名独立的成年游客。其中，54931人口头参与了测试，没有选择退出。共有34848人接受了HCV抗体检测，其中3665例（10.5%）患者出现反应性结果。在所有Ab阳性患者中进行了反射性RNA确证试验，其中1601例（50.3%）阳性。大多数HCV抗体和RNA阳性患者是年轻人，出生于1965年以后，更可能是白色、男性、医疗补助保险人，并报告有注射毒品使用史。艾德非靶向、选择退出检测可以发现成年访客中HCV感染的高患病率。年轻的白色人中丙型肝炎病毒感染率高得不成比例，这可能反映了阿巴拉契亚地区阿片类药物注射和丙型肝炎病毒传播的流行病不断升级。我们的HCV筛查研究来自艾德，服务于受阿片类药物流行严重影响的阿巴拉契亚地区，显示了与Ab和RNA阳性患者相关的筛查和流行病学发现的初步结果。
We describe the initial results of an adult academic emergency department (ED) nontargeted hepatitis C virus (HCV) screening program serving Appalachia, which is disproportionately affected by the opioid epidemic. The study was a retrospective screening study of ED systematic, nontargeted, opt-out HCV testing outcomes from July 2018 through September 2020. Eligibility requirements for “nontargeted” HCV testing included age ≥18 years, verbally able to communicate, receiving bloodwork already as part of routine clinical care, and not opting out of testing. For eligible individuals who did not opt out of testing, an HCV antibody (Ab) test was performed. Reactive Ab tests were confirmed with reflexive HCV RNA testing. The primary study outcome was the characterization of HCV Ab and RNA prevalence. There were 75 722 unique adult visitors during the period studied. Of these, 54 931 individuals were verbally engaged regarding testing and did not opt out. A total of 34 848 individuals received HCV Ab testing, with 3665 patients (10.5%) having reactive results. RNA confirmatory testing was reflexively performed in all Ab-positive patients, with 1601 (50.3%) positive. The majority of HCV Ab– and RNA-positive patients were young, born after 1965, and were more likely to be White, male, Medicaid insured, and report a history of injection drug use. ED nontargeted, opt-out testing can identify a high prevalence of HCV infection among adult visitors. HCV infection was disproportionately high among younger, White individuals, likely reflecting the escalating syndemic of opioid injection and HCV transmission in Appalachia. Our HCV screening study from an ED serving Appalachia, a region severely impacted by the opioid epidemic, displays initial results from screening and epidemiological findings associated with Ab and RNA positive patients.
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影响因子：
12.6
作者：
Lo Re, Vincent, III;Gowda, Charitha;Kostman, Jay R.
通讯作者：
Kostman, Jay R.
影响因子：
33.9
作者：
Ryerson, A. Blythe;Schillie, Sarah;Wester, Carolyn
通讯作者：
Wester, Carolyn
影响因子：
4.4
作者：
Wojcik, Elena M.;Sharon, Melinda J.;Burrell, Carmen N.
通讯作者：
Burrell, Carmen N.
影响因子：
11.8
作者：
Hsieh, Yu-Hsiang;Rothman, Richard E.;Quinn, Thomas C.
通讯作者：
Quinn, Thomas C.
在2030年注射毒品的人们中，消除HCV是公共卫生的关注 - 到达那里需要什么？
影响因子：
6
作者：
Grebely J;Dore GJ;Morin S;Rockstroh JK;Klein MB
通讯作者：
Klein MB