深圳市宝安区565例丙型肝炎确诊病例抗病毒治疗情况及其影响因素

Analysis of antiviral treatment and its influencing factors among 565 patients diagnosed with hepatitis C in Bao’an district, Shenzhen

目的了解深圳市宝安区2017-2019年丙型肝炎(简称丙肝)确诊病例抗病毒治疗情况,分析影响病例接受治疗的因素。方法依据中国疾病预防控制中心制定的以医疗机构为基础的丙肝哨点监测工作方案,由首诊医生对监测期内所有本院新诊断的丙肝确诊病例收集诊疗信息,通过流行病动态数据采集平台录入数据,并对病例治疗情况进行统计分析。结果共收集565例丙肝确诊病例,男性占65.0%,女性占35.0%,平均年龄(44.7±13.2)岁。74例病例进行了抗病毒治疗,占13.1%,直接抗病毒药物治疗占9.9%(56例)。经趋势χ^2检验分析,2017-2019年间抗病毒治疗率呈递增趋势(10.2%、13.9%、19.5%)(P=0.009)。非条件Logistic回归分析显示,不同年份、不同实验室检测原因、既往是否接受过丙肝治疗的病例组其抗病毒治疗率的差异具有统计学意义(P<0.05)。结论深圳市宝安区丙肝确诊病例抗病毒治疗率呈逐年递增趋势,但离世界卫生组织80%的治疗率目标仍有很大差距。要重点关注首次确诊、从未治疗的病例,提高医疗机构丙肝服务可及性。

Objective To investigate the treatment rate of patients with hepatitis C virus(HCV)infection receiving antiviral therapy in Bao’an district of Shenzhen from 2017 to 2019,and analyze the influencing factors.Methods According to the HCV surveillance scheme by the Chinese Center for Disease Control and Prevention,the physicians in medical institutions collected information on diagnosis and treatment of the newly detected HCV patients during the surveillance period,and submitted the case reports to the epidemiological dynamic data collection platform.Unconditional logistic regression was performed to analyze the surveillance data and factors influencing the treatment.Results A total of 565 patients with HCV infection were recruited,of which 65.0%were males and 35.0%females,with an average age of 44.7±13.2 years.A number of 74 patients received antiviral treatment,accounting for 13.1%of the entire study samples,and 9.9%(N=56)were treated with direct-acting antiviral agents.The antiviral treatment rate increased from 10.2%in 2017 to 19.5%in 2019(P=0.009).Three factors significantly influenced the treatment rate,including year,lab location,and previous HCV treatment experience(P<0.05).Conclusion The antiviral treatment rate of HCV patients in Bao’an district of Shenzhen increased from 2017 to 2019.It is still far below the goal of 80%antiviral treatment rate set up by the World Health Organization.We should focus on the first confirmed or never treated cases,and improve the accessibility of hepatitis C services in medical institutions.