Anti-HCV and ALT were included in a routine check-up together with a questionnaire covering risk factors. HCV-RNA was analysed in anti-HCV-positive individuals.
In urban and rural areas, 4323 and 9321 individuals were recruited. The anti-HCV prevalence was 0.56% and 0.49%, and 0.1% of patients were HCV-RNA-positive in both regions. Fifty-two anti-HCV positive patients including eight HCV-RNA-positive cases were unaware of the infection (number needed to screen to detect one unknown anti-HCV-positive individual: 262). At least one of the three aforementioned risk factors or elevated serum ALT was present in 3000 patients (22%). Restricting HCV screening to only those with risk factors, 52% and 75% of all anti-HCV and HCV-RNA-positive undiagnosed patients were identified (number needed to screen: 111).
We confirm prospectively the efficiency of a risk-based HCV screening. The risk-based algorithm should be evaluated in other countries with similarly low HCV prevalence as in Germany to achieve WHO HCV elimination goals.
方法:常规检查包括抗HCV和ALT以及涵盖风险因素的问卷。在抗HCV阳性个体中分析HCV-RNA。
结果:在城市和农村地区,招募了4323人和9321人。抗-HCV患病率分别为0.56%和0.49%,0.1%的患者在两个地区均为HCV-RNA阳性。包括8例HCV-RNA阳性病例在内的52例抗HCV阳性患者未意识到感染(需要筛选以检测一名未知的抗HCV阳性个体的人数:262)。在3000名患者中存在上述三个危险因素中的至少一个或升高的血清ALT(22%)。限制HCV筛查仅适用于有危险因素的人群,所有抗-HCV和HCV-RNA阳性的未诊断的患者中有52%和75%被鉴定(需要筛选的人数:111)。
结论:我们前瞻性地确认了基于风险的HCV筛查的有效性。应在与德国相似的低HCV流行率的其他国家评估基于风险的算法,以实现WHOHCV消除目标。