丙型肝炎筛查的微量消除倡议：洞察性别差距和未确诊个体。

Micro-elimination initiative for hepatitis C screening: insight into gender gaps and undiagnosed individuals.

作者信息

Piazzolla Annarita Valeria, Resta Domenico, Greco Massimo, Comes Vito, Vassalli Teresa, Mengoli Federico, Memoli Elvira, Checchia Donato, Migliorelli Nazario, Giuliani Giovanni, Giannattasio Giuditta, Checchia Rosaria Maria, Giannone Antonia, Noya Attilio, Pugliese Domenico, Carrisi Cristina, Murgo Grazia, Carretta Vito, Gentile Leonardo, Ongaro Lorenzo, Parisi Giacomo, Costantino Domenico, Giubba Amedeo, Squillante Maria Maddalena, Mangia Alessandra

机构信息

Farmacia Resta, Taranto, Italy.

Farmacia Grasso, Lecce, Italy.

出版信息

Sci Rep. 2025 Mar 18;15(1):9289. doi: 10.1038/s41598-025-91696-4.

DOI:10.1038/s41598-025-91696-4

PMID:40102477

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11920028/

Abstract

In 2023, the Italian healthcare system launched HCV screening targeting subjects born in 1968-1989. However, subjects > 50 yrs also need screening. In addition, existence of gender gaps in HCV diagnosis and treatment has been suggested. Our aim was to identify undiagnosed individuals outside the age groups to whom the screening is offered and to gather data about gender gaps. This is a prospective, opportunistic micro-elimination initiative based on a network between 24 Apulian pharmacies and our center. Between 01/07/2022 and 01/03/2024, subjects aged 55 to 85, accessing pharmacies were offered HCVOraQuick tests (F/M 1:1) and administered ad-hoc questionnaires. In total, 13,042 screening were carried out. Mean age was 64.9 (± 7.6), 51.1% females. Overall, 1.1% were anti-HCV positive: mean age 68.3 (± 10.3), 44.9% females. Seroprevalence was higher in males (p < 0.00001), elderly (p < 0.00001) and unknown transmission route (p = 0.0009). HCV-RNA was detectable in 67.4% of seropositive. They were 67.5 (± 10.7) yrs old, mainly males (55.1%). HCV-RNA prevalence was 0.8%, higher in elderly (p = 0.0003) and unknown transmission route (p = 0.0007). Overall, 90% were linked-to-treatment. Differences in patients profiles should be considered to guide policy and more inclusive treatment approaches. Gender differences in screening response and rates of active infections underscore the need for gender-targeted intervention.

摘要

2023年，意大利医疗保健系统针对1968年至1989年出生的人群开展了丙型肝炎病毒（HCV）筛查。然而，年龄超过50岁的人群也需要进行筛查。此外，有研究表明，HCV诊断和治疗中存在性别差异。我们的目标是识别未被纳入筛查年龄组的未确诊个体，并收集有关性别差异的数据。这是一项前瞻性、机会性的微量消除倡议，基于24家阿普利亚药店与我们中心之间的网络开展。在2022年7月1日至2024年3月1日期间，年龄在55至85岁之间、前往药店的人群接受了HCV OraQuick检测（男女比例为1:1），并填写了专门设计的问卷。总共进行了13042次筛查。平均年龄为64.9岁（±7.6岁），女性占51.1%。总体而言，1.1%的人抗HCV呈阳性：平均年龄68.3岁（±10.3岁），女性占44.9%。男性（p<0.00001）、老年人（p<0.00001）以及传播途径不明者（p=0.0009）的血清阳性率更高。67.4%的血清阳性者可检测到HCV-RNA。他们的年龄为67.5岁（±10.7岁），主要为男性（55.1%）。HCV-RNA患病率为0.8%，老年人（p=0.0003）和传播途径不明者（p=0.0007）的患病率更高。总体而言，90%的患者已接受治疗。应考虑患者特征的差异，以指导政策制定和更具包容性的治疗方法。筛查反应和活动性感染率方面的性别差异凸显了针对性别进行干预的必要性。