珠海丙型肝炎微消除行动“福星计划”结果分析  

Analysis of the results of the Fuxing Program Action for micro-elimination of hepatitis C in Zhuhai

作　　者：郑新春 欧梦党[1] 李颖[1] 邹幼清 邱利娣 洪仲思[1] 夏瑾瑜[1] Zheng Xinchun;Ou Mengdang;Li Ying;Zou Youqing;Qiu Lidi;Hong Zhongsi;Xia Jinyu(Infectious Disease Prevention and Treatment Center,the Fifth Affiliated Hospital of Sun Yat-Sen University,Zhuhai 519000,China)

机构地区：[1]中山大学附属第五医院感染病防治中心,珠海519000

出　　处：《中华肝脏病杂志》2025年第2期135-142,共8页Chinese Journal of Hepatology

基　　金：珠海市疾病预防控制中心2022年珠海市艾滋病防治项目(ZHWZ2022-187FW);珠海市消除丙型肝炎项目。

摘　　要：目的为响应世界卫生组织“2030年消除病毒性肝炎作为公共卫生危害”的目标,珠海建立了丙型肝炎微消除行动计划——“福星计划”项目,并评估其在丙型肝炎筛查、治疗和随访方面的有效性。方法2021年5月在珠海市感染性疾病医疗质量控制中心主导下,“福星计划”项目通过政府、各级医院和社区之间构建桥梁,进行丙型肝炎防治策略培训、开展院内和院外丙型肝炎筛查和宣传教育,设立丙型肝炎专门工作人员负责患者诊治和随访。通过χ^(2)检验或Fisher's精确检验对比分析项目启动前后院内丙型肝炎筛查和治疗率。调查分析珠海市社区、农村、学校或工厂普通人群和高风险人群如人类免疫缺陷病毒(HIV)感染、戒毒及其他监管场所人群丙型肝炎病毒(HCV)感染和治疗状况。结果“福星计划”启动后,院内就诊人群抗-HCV阳性率(0.82%比0.43%,P<0.001)、HCV RNA检测率(98.1%比59.5%,P<0.001)、HCV RNA检测阳性率(52.56%比29.76%,P<0.001)、HCV RNA阳性率(0.4%比0.13%,P<0.001)和丙型肝炎治疗率(76.76%比31.97%,P<0.001)明显高于“福星计划”启动前。珠海市内“福星计划”启动后HCV RNA检测率(58.52%比6.93%,P<0.001)和HCV RNA检测阳性率(77.72%比29.41%,P<0.001)明显高于启动前。珠海城市社区普通人群抗-HCV阳性率(0.46%比1.28%,P=0.009)和HCV RNA阳性率(0.32%比0.99%,P=0.03)明显低于农村普通人群,农村人群HCV感染率是城市人群的3倍多。在HIV感染、监管场所被监管人群和美沙酮诊所就诊人群中,抗-HCV阳性率分别为2.64%(31/1175)、3.40%(69/2022)和94.4%(34/36),HCV RNA阳性率分别为2.64%(31/1175)、2.72%(55/2022)和50.00%(18/36),HCV RNA检测阳性率分别为100%(31/31)、79.71%(55/69)和52.94%(18/34),丙型肝炎治疗率分别为100%(31/31)、0(0/55)和55.55%(10/18)。高危人群抗-HCV阳性率(4.15%比0.72%,P<0.001)和HCV RNA阳性率(3.22%比0.53%,P<0.001)明显高于普通人群,而高危人群丙�Objective The Fuxing Program was established in Zhuhai as an action plan to micro-eliminate hepatitis C in response to the World Health Organization's goal of eliminating hepatitis C by 2030.Therefore,the effectiveness of this program in terms of hepatitis C screening,treatment,follow-up,and other aspects is evaluated here.Methods The"Fuxing Project"was established in May 2021 under the supervision of the Zhuhai Medical Quality Control Center for Infectious Diseases.A bridge was formed among the governmental entities,hospitals at all levels,and the community to train hepatitis C prevention and control strategies.Hepatitis C screening,publicity,and educational awareness were conducted in-and out-of-hospital.The responsibility for the diagnosis,treatment,and follow-up of a patient with hepatitis C was assigned to the staff.The screening and treatment rates of hepatitis C in hospitals before and after the initiation of the project were compared and analyzed using the χ^(2) test or Fisher's exact test.The hepatitis C virus(HCV)infection and treatment status were investigated and analyzed among the general population,high-risk populations such as human immunodeficiency virus(HIV)infection,drug addicts,and the population residing in supervised sites within Zhuhai communities,rural areas,schools,or factories.Results Anti-HCV positivity rate(0.82%vs.0.43%,P<0.001),HCV RNA detection rate(98.1%vs.59.5%,P<0.001),HCV RNA detection positivity rate(52.56%vs.29.76%,P<0.001),HCV RNA positivity rate(0.4%vs.0.13%,P<0.001),and hepatitis C treatment rate(76.76%vs.31.97%,P<0.001)were significantly higher among the inpatient population after the Fuxing Program initiation than before.The HCV RNA detection rate(58.52%vs.6.93%,P<0.001)and HCV RNA detection positivity rate(77.72%vs.29.41%,P<0.001)in Zhuhai were significantly higher after the Fuxing Program initiation than before.Anti-HCV positivity rate(0.46%vs.1.28%,P=0.009)and HCV RNA(0.32%vs.0.99%,P=0.03)were significantly lower in the Zhuhai general population of urban communities th

关 键 词：丙型肝炎 丙型肝炎病毒感染 丙型肝炎微消除 管理模式 筛查 治疗 

分 类 号：R51[医药卫生—内科学]