世界卫生组织全球肝炎战略的目标是到2030年消除慢性丙型肝炎病毒(HCV)感染。作为其战略的一部分,联邦联合委员会(德国)决定将乙型肝炎和丙型肝炎筛查纳入预防性医学检查,这是在德国的初级保健水平进行的。我们调查了2021年10月至2022年9月实施筛查1年后的结果。
■HBsAg/HBVDNA和抗HCV/HCVRNA筛查是通过11个门诊医疗中心的286,192个人的计费类别确定的。
■与2018年的30,106HBsAg和31,266抗HCV实验室要求相比,在筛查期间,测试数量增加到286,192。与常规护理相比,在35-44岁的人群中,额外的抗-HCV阳性测试年龄依赖性增加了98%(男性177+170例阳性病例)和123%(女性96+118例阳性病例),在75-84岁的人群中增加了518%(男性17+88例阳性病例)和514%(女性29+149例阳性病例).对于HBsAg观察到类似的结果。HBsAg的患病率,抗HCV和HCVRNA为0.54%,0.79%和0.13%,分别。
■已成功建立了初级保健一级的结构化肝炎筛查计划,与常规护理相比,该计划可产生年龄和性别依赖性的大量额外影响。
■消除慢性乙型肝炎和丙型肝炎病毒感染的策略是国家特定的,并且在临床方案之间有所不同。我们的分析证明了初级保健医生筛查计划与低患病率国家的常规护理相比的有效性。该计划应伴随着风险人群的额外努力,例如在当前筛查方法中代表性不足的注射毒品的人。
UNASSIGNED: A goal of the World Health Organization\'s global hepatitis strategy is the elimination of chronic hepatitis C virus (HCV) infection by 2030. As part of its strategy, the Federal Joint Committee (Germany) decided to include hepatitis B and C screening in a preventive medical examination, which is performed at the primary care level in Germany. We investigated the results 1 year after implementation of screening between October 2021 and September 2022.
UNASSIGNED: HBsAg/HBV DNA and anti-HCV/HCV RNA screenings were identified by billing categories in 286,192 individuals of 11 ambulatory healthcare centers.
UNASSIGNED: Compared to 30,106 HBsAg and 31,266 anti-HCV laboratory requisitions in the year 2018, the number of tests increased to 286,192 during the screening period. Compared to routine care, additional anti-HCV positive tests age dependently increased the tally by 98% (177 plus 170 positive cases in males) and 123% (96 plus 118 positive cases in females) in those aged 35-44 years up to 518% (17 plus 88 positive cases in males) and 514% (29 plus 149 positive cases in females) in those aged 75-84 years. Similar results were observed for HBsAg. Prevalences of HBsAg, anti-HCV and HCV RNA were 0.54%, 0.79% and 0.13%, respectively.
UNASSIGNED: A structured hepatitis screening program at the primary care level has been successfully established and leads to age- and-sex-dependent large additional effects compared to routine care.
UNASSIGNED: Strategies to eliminate chronic hepatitis B and C virus infection are country specific and vary between clinical scenarios. Our analysis proves the efficacy of a screening program by primary care physicians compared to routine care in a low-prevalence country. This program should be accompanied by additional efforts in risk populations like people who inject drugs who are under-represented in the current screening approach.