Chronic hepatitis C virus (HCV) infection causes substantial morbidity and mortality in the United States. Testing and treatment of asymptomatic persons might avert progression to more advanced disease. In 1998, CDC published guidelines for HCV testing based on risk factors for infection; however, recent studies indicate that at least one half of all persons living with HCV infection in the United States are unaware of their infection status. To increase testing rates, in 2012 CDC recommended one-time testing of all persons born during 1945-1965. To better understand where and why persons with chronic HCV infection sought their initial testing, 2006-2010 data were analyzed from a survey conducted as part of the ongoing Chronic Hepatitis Cohort Study. Of 4,689 patients with HCV infection who responded to the survey, 60.4% reported that their initial HCV test occurred in a physician's office. CDC's risk-based indications (e.g., injection drug use and hemodialysis) were cited by 1,045 (22.3%) of the patients as reasons for testing, whereas clinical indications (e.g., abnormal liver function tests or liver-related symptoms such as jaundice) were cited by 2,121 (45.2%), suggesting that many HCV infections were identified only after the patient had become symptomatic. Promoting U. S. Preventive Services Task Force and CDC recommendations for testing and identifying strategies that help physicians implement HCV testing in their offices might help facilitate timely identification of HCV infection and reduce morbidity and mortality.

译文

:慢性丙型肝炎病毒(HCV)感染在美国引起大量发病和死亡。无症状者的测试和治疗可能会避免病情恶化。 1998年,疾病预防控制中心发布了基于感染危险因素的HCV检测指南;但是,最近的研究表明,在美国,所有感染HCV的人中至少有一半不知道其感染状况。为了提高检测率,CDC于2012年建议对1945-1965年间出生的所有人进行一次性检测。为了更好地了解慢性HCV感染者在何处以及为什么要进行初次检查,我们从一项正在进行的慢性肝炎队列研究中进行的调查中分析了2006-2010年的数据。在接受调查的4689例HCV感染患者中,有60.4%的人报告说他们最初的HCV测试发生在医生的办公室。 1,045(22.3%)的患者将CDC基于风险的指征(例如,注射药物的使用和血液透析)作为测试的原因,而临床指征(例如,异常的肝功能测试或与肝有关的症状,例如黄疸)被引用为CDC。被2,121(45.2%)引用,表明只有在患者出现症状后才发现许多HCV感染。促进美国预防服务工作队和CDC关于检测和确定有助于医师在其办公室进行HCV检测的策略的建议,可能有助于促进及时识别HCV感染并降低发病率和死亡率。

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