4.6 Article

Hepatitis C Screening in Post-Baby Boomer Generation Americans: One Size Does Not Fit All

期刊

MAYO CLINIC PROCEEDINGS
卷 98, 期 9, 页码 1335-1344

出版社

ELSEVIER SCIENCE INC
DOI: 10.1016/j.mayocp.2023.02.009

关键词

-

向作者/读者索取更多资源

The study aims to analyze the impact of health insurance coverage on HCV infection prevalence in US adults born after 1965 and formulate strategies for population screening. The results show higher HVC prevalence in uninsured individuals, and alanine aminotransferase prescreening can effectively reduce the number of screenings.
Objectives: To analyze the impact of access to routine health care, as estimated by health insurance coverage, on hepatitis C virus (HCV) infection prevalence in US adults born after 1965 (post -baby boomer birth cohort [post-BBBC]) and to use the data to formulate strategies to optimize population screening for HCV.Patients and Methods: Adult examinees in the National Health and Nutrition Examination Survey with available anti-HCV data were divided into era 1 (1999-2008) and era 2 (2009-2016). The prevalence of HCV infection, as defined by detectable serum HCV RNA, was determined in post-BBBC adults. In low prevalence groups, prescreening modalities were considered to increase the pretest probability.Results: Of 16,966 eligible post-BBBC examinees, 0.5% had HCV infection. In both eras, more than 50% had no insurance. In era 2, HCV prevalence was 0.26% and 0.83% in those with and without insurance, respectively (P<.01). As a prescreening test, low alanine aminotransferase level (<23 U/L in women and 32 U/L in men) would identify 54% of post-BBBC adults with an extremely low (0.02%) HCV prevalence. Based on these data, a tiered approach that tests all uninsured directly for HCV and prescreens the insured with alanine aminotransferase would reduce the number to test by 56.5 million while missing less than 1% infections.Conclusion: For HCV elimination, passive universal screening in routine health care settings is insufficient, although the efficiency of screening may be improved with alanine aminotransferase prescreening. Importantly, for individuals with limited access to health care, proactive outreach programs for HCV screening are still needed.(c) 2023 Published by Elsevier Inc on behalf of Mayo Foundation for Medical Education and Research

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.6
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据