常态化随访实施院内丙型肝炎微消除策略效果评价*

doi:10.3969/j.issn.1672-5069.2025.05.009

实用肝脏病杂志 ›› 2025, Vol. 28 ›› Issue (5): 675-678.doi: 10.3969/j.issn.1672-5069.2025.05.009

常态化随访实施院内丙型肝炎微消除策略效果评价^*

郝帅, 王梓依, 张心怡, 张粉娜, 苏娜, 贺娜

710006 西安市西安医学院第一附属医院消化内科(郝帅,贺娜,张粉娜,苏娜);西安医学院(郝帅,王梓依,张心怡)

收稿日期:2024-11-29 出版日期:2025-09-10 发布日期:2025-09-19
通讯作者: 贺娜,E-mail:ylhena@163.com
作者简介:郝帅,男,26岁,硕士研究生,住院医师。E-mail:635616294@qq.com
基金资助:
*佑安肝病感染病专科医疗联盟专项基金资助项目(编号:LM202003);陕西省教育科学“十三五”规划研究项目(编号:SGH20Y1330)

Normalized follow-up for hepatitis C micro-elimination strategy in a general tertiary hospital

Hao Shuai, Wang Ziyi, Zhang Xinyi, et al

Department of Gastroenterology, First Affiliated Hospital, Xi'an Medical College, Xi'an 710006, Shaanxi Province, China

Received:2024-11-29 Online:2025-09-10 Published:2025-09-19

摘要/Abstract

摘要： 目的本研究旨在探讨常态化随访在院内丙型肝炎微消除(MES)策略中的应用价值。方法检索2020年10月～2022年5月就诊于我院行血清抗-HCV和HCV RNA检测为阳性的住院患者,并通过电话和短信联系进行常态化随访及召回,收集其进一步诊疗信息。结果经常态化随访后,血清抗-HCV筛查率和HCV RNA检测率分别为83.7%和83.5%,显著高于回顾性研究的70.6%和72.3%(x²=3141.888,P <0.001;x²=25.474,P<0.001);常态化随访中失访患者人数占总随访人数的28.0%,较回顾性研究的44.8%显著降低(x²=23.439,P <0.001);对丙型肝炎知识了解的患者占比高达72.0%,66.0%患者表示积极的治疗意愿,21.0%患者态度一般,仅有13.0%患者治疗态度消极;常态化随访有效召回率为44.3%,显著高于回顾性研究的32.9%(x²=4.183,P <0.05);在122例召回患者中,全部启动DAA抗病毒治疗,除治疗结束失访1例外,治疗结束病毒学应答率和持续病毒学应答率(SVR24/SVR48)分别为98.3%(120/122)和100.0%(121/121)/100.0%(121/121)。结论应用常态化随访作为院内丙型肝炎MES策略的重要举措之一,具有简单易行、成本低、可持续等优点,在提高丙型肝炎筛查率、确诊率和提高抗病毒治愈,从而达到丙型肝炎MES方面具有显著的效果,值得推广应用。

关键词: 丙型肝炎, 丙型肝炎微消除, 随访, 抗病毒, 治疗

Abstract: Objective The purpose of this study was to investigate normalized follow-up for hepatitis C micro-elimination strategy (MES) in a general tertiary hospital. Methods The clinical materials of hospitalized patients with serum anti-HCV and/or HCV RNA positive in our hospital between October 2020 and May 2022 were retrieved, and all patients were informed by phone call or text message for them recall. Results Rates of serum anti-HCV screening and HCV RNA load detection after normalized follow-up were 83.7% and 83.5%, both were significantly higher than 70.6% and 72.3% (x²=3141.888, P<0.001;x²=25.474, P <0.001) in the past period; patients lost to followed-up in the normalized follow-up period was 28.0%, significantly lower than 44.8% (x²=23.439, P <0.001) in the past; percentage of patients with knowledge of hepatitis C prevention and treatment was as high as 72.0%, and 66.0% of patients expressed positive, 21.0% expressed inactive and only 13.0% had negative attitude towards antiviral treatment intention; effective recall rate in normalized follow-up perios was 44.3$, much higher than 32.9% (x²=4.183, P<0.05) in the past; of 122 successfully recalled patients, direct antiviral agent therapy was initiated in all, all except for one who lost visit achieved sustained virological response (SVR24 of 100.0%(121/121)/SVR48 of 100.0%(121/121). Conclusion The in-hospital hepatitis C MES has the advantages of simple, low cost and sustainability, which might help achieving goals of elimination of hepatitis C in the near future.

Key words: Hepatitis C, Micro-elimination strategies, Follow-up, Antiviral therapy

郝帅, 王梓依, 张心怡, 张粉娜, 苏娜, 贺娜. 常态化随访实施院内丙型肝炎微消除策略效果评价^*[J]. 实用肝脏病杂志, 2025, 28(5): 675-678.

Hao Shuai, Wang Ziyi, Zhang Xinyi, et al. Normalized follow-up for hepatitis C micro-elimination strategy in a general tertiary hospital[J]. Journal of Practical Hepatology, 2025, 28(5): 675-678.

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常态化随访实施院内丙型肝炎微消除策略效果评价^*

Normalized follow-up for hepatitis C micro-elimination strategy in a general tertiary hospital

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