| ObjectiveTo understand the current status of nucleic acid detection for HCV antibody positive patients and antiviral treatment for HCV RNA positive patients in medical institutions in Zhumadian.To analysis the possible factors influencing HCV RNA testing for HCV antibody positive patients and antiviral therapy for HCV RNA positive patients,providing a basis for further promotion of the diagnosis and treatment of hepatitis C.MethodsBy using the cross-sectional method,we investigated individuals over 18 years old who was identified as hepatitis C antibody-positive(including former positives and newly detected positives)from five hospitals with HCV RNA testing qualification and antiviral treatment capacity in Yicheng,Pingyu,Runan and Miyang during the period of May-August 2019.On-site investigation and follow-up investigations were conducted in this survey.For hospitalized patients and liver disease related outpatients found in the department of infectious disease,we mainly used on-site investigation.Telephone follow-up surveys were conducted on hepatitis C antibody-positive people who were screened in other departments and those who were missed in the on-site survey.We collected demographic information,family financial status,personal privacy issue,access to health care,hepatitis C knowledge,treatment information,doctor information and laboratory test information for those with positive results of hepatitis C antibody tests.The description of the count data is based on the frequency distribution.The univariate and multivariate analysis are based on binary logistic regression.The statistical test level is 0.05.Results1.Current status of nucleic acid detection:A total of 416 positive cases of hepatitis C antibody were collected,and the nucleic acid detection rate was 58.41%(243/416),the positive rate was 82.72%(201/243).Multivariate regression analysis showed that the detection rate of respondents with 2000?2999 yuan per person per month(OR=5.36,95%CI:1.55?18.53)and more than 3,000 yuan per person per month(OR=8.39,95%CI:2.01?35.01)were higher than respondents with less than 1000 yuan per person per month;the nucleic acid detection rate of self-driving patients(OR=4.30,95%CI:1.46?12.69)was higher than that of public transport patients;the nucleic acid detection rate of the respondents who knew the knowledge of hepatitis C(OR=1.89,95%CI:1.06?3.38)was higher than that of the unknown;the nucleic acid detection rate of the respondents whose hepatitis C infection status was known by the family(OR=5.11,95%CI:1.27?20.49)was higher than that of the unknown;compared with the respondents who tested hepatitis C before medical service,the detection rate of patients with liver disease symptoms(OR=3.78,95%CI:1.15?12.46)was higher;the rate of detection of nucleic acid in infectious department(OR=11.17,95%CI:3.61?34.55)and gastroenterology department(OR=8.65,95%CI:2.38?19.74)was higher than the surgery department.2.Overall treatment status:Among HCV RNA negative patients,after excluding previous HCV antibody positive patients,antiviral treatment and liver protection/protection therapy accounted for 13.42%(53/395)and 31.14%(123/395),respectively.Among those without HCV RNA detection,5.78%(10/173)were treated with antiviral therapy.Among HCV RNA negative patients,antiviral treatment accounted for 9.52%(2/21).Among the patients receiving antiviral therapy,22.74%(12/53)of the respondents had no indications for antiviral therapy.3.Current status of antiviral therapy:Among 201 positive nucleic acid patients,the antiviral treatment rate was 20.40%(41/201).Multivariate regression analysis showed that the treatment rate of respondents with high school education or above(OR=5.31,95%Cl:1.04?27.11)was higher than that of primary school or below;the treatment rate of respondents with more than 3000 yuan per person per month(OR=8.12,95%CI:1.83?36.14)was higher than that of respondents with less than or equal to 1999 yuan;the antiviral treatment rate of those who knew hepatitis C knowledge(OR=2.73,95%Cl:1.10-6.73)was higher than that of those who were unknown;the rate of detection of antibodies after symptoms appeared(OR=5.40,95%CI:1.72?16.93)was higher than that of medical screening.Conclusion1.The HCV RNA detection rate among HCV positive individuals in the surveyed areas has exceeded 50%,but there is still large room for improvement due to various factors such as patients' financial status,whether the families know about the patients' infection,and clinics.Therefore,reducing the medical burden of poor patients(reduce the cost of testing or include testing in health insurance),and at the same time,trying to obtain the cooperation of family members in the treatment process,taking the initiative to go to the liver clinic can increase the motivation of patients to seek medical treatment and increase the rate of HCV RNA testing in this population.2.Among the patients receiving antiviral therapy,there were some respondents without treatment indications.The antiviral therapy rates in HCV RNA-positive individuals is low.Poor family economic status and insufficient awareness of the dangers of hepatitis C were the main reasons why this population did not receive antiviral therapy.Therefore,It is recommended that patients be treated with antiviral drugs covered by the medical insurance to reduce the medical burden.At the same time,patients are encouraged to consult their doctors about HCV related problems,so as to eliminate doubts about their condition and improve their enthusiasm for antiviral treatment. |
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