基于COE项目的湖南省某三级甲等医院院内HCV微消除模式探索与效果评价OA
Exploration and effect evaluation of in-hospital HCV micro-elimination model based on the COE program in a tertiary first-class hospital in Hunan Province
目的 探索并评价湖南省某三级甲等医院针对丙型肝炎病毒(HCV)实施的卓越中心项目(COE),为建立与应用院内 HCV微消除模式,制定消除 HCV策略,以及加速实现世界卫生组织(WHO)2030目标提供参考依据.方法 收集该院2022年1月—2025年2月就诊的抗-HCV或 HCV RNA阳性患者相关数据,其中2022年1-12月为COE项目实施前,2023年3月—2025年2月为COE项目实施后.分析项目实施前后 HCV RNA检测率、治疗率、会诊率等指标.结果 2022年1-12月共有902例抗-HCV阳性患者,2023年3月—2025年2月共有2 389例抗-HCV或 HCV RNA阳性患者.COE项目实施前后,感染科 HCV RNA检测率、治疗率均高于非感染科室(实施前:83.0%VS 23.4%;68.4%VS 36.8%,均 P<0.001.实施后:90.1%VS 42.1%;86.5%VS 65.7%,均P<0.001).COE项目实施后,全院、感染科、非感染科的 HCV RNA检测率、治疗率均有显著提升(全院:50.0%VS 36.6%,75.5%VS 50.7%;感染科:90.1%VS 83.0%,86.5%VS 68.4%;非感染科:42.1%VS 23.4%,65.7%VS 36.8%,均P<0.001),非感染科的转诊率亦显著提高(12.9%VS 8.9%,P<0.05).结论 湖南省某三级甲等医院通过丙型病毒性肝炎COE项目施行的 HCV微消除模式可行且成效明显,可为临床丙型病毒性肝炎消除工作提供较高价值的参考.
Objective To explore and evaluate the Center of Excellence(COE)program for hepatitis C virus(HCV)implemented in a tertiary first-class hospital in Hunan Province,so as to provide references for the estab-lishment and application of an in-hospital HCV micro-elimination model,formulation of HCV elimination strate-gies,and acceleration of the achievement of the WHO 2030 HCV elimination targets.Methods Data relevant to patients who were positive for anti-HCV or HCV RNA and visited the hospital from January 2022 to February 2025 were collected.January-December 2022 and March 2023-February 2025 were the pre-and post-COE implementation periods.Key indicators,including HCV RNA testing rate,treatment rate and consultation rate of hepatitis C before and after the implementation of the program were analyzed.Results A total of 902 patients were tested positive for anti-HCV from January to December 2022,while 2 389 patients were tested positive for anti-HCV or HCV RNA from March 2023 to February 2025.Before and after the implementation of the COE program,HCV RNA testing rate and hepatitis C treatment rate in the department of infectious diseases were both significantly higher than those in departments of non-infectious diseases(pre-implementation:83.0%vs 23.4%,68.4%vs 36.8%,respectively,both P<0.001;post-implementation:90.1%vs 42.1%,86.5%vs 65.7%,respectively,both P<0.001).After the implementation of the COE program,HCV RNA testing rate and hepatitis C treatment rate both improved significantly in the whole hospital,department of infectious diseases and departments of non-infectious diseases(whole hospital:50.0%vs 36.6%,75.5%vs 50.7%,respectively;department of infectious diseases:90.1%vs 83.0%,86.5%vs 68.4%,respectively;departments of non-infectious diseases:42.1%vs 23.4%,65.7%vs 36.8%,respectively,all P<0.001).Additionally,the referral rate of departments of non-infectious diseases also increased significantly(12.9%vs 8.9%,P<0.05).Conclusion The HCV micro-elimination model implemented through the hepatitis C COE program in a tertiary first-class hospital in Hunan Province is feasible and remarkably effective,which can provide high-value reference for clinical hepatitis C elimination.
陈莹;杨雪瑶;陈君;黄泽炳;黄燕
中南大学湘雅医院感染病科,湖南 长沙 410008||病毒性肝炎湖南省重点实验室,湖南 长沙 410008||老年疾病国家临床医学研究中心(湘雅医院),湖南 长沙 410008中南大学湘雅医院感染病科,湖南 长沙 410008||病毒性肝炎湖南省重点实验室,湖南 长沙 410008||老年疾病国家临床医学研究中心(湘雅医院),湖南 长沙 410008中南大学湘雅医院感染病科,湖南 长沙 410008||病毒性肝炎湖南省重点实验室,湖南 长沙 410008||老年疾病国家临床医学研究中心(湘雅医院),湖南 长沙 410008中南大学湘雅医院感染病科,湖南 长沙 410008||病毒性肝炎湖南省重点实验室,湖南 长沙 410008||老年疾病国家临床医学研究中心(湘雅医院),湖南 长沙 410008中南大学湘雅医院感染病科,湖南 长沙 410008||病毒性肝炎湖南省重点实验室,湖南 长沙 410008||老年疾病国家临床医学研究中心(湘雅医院),湖南 长沙 410008
医药卫生
丙型肝炎病毒微消除模式探索COE项目
hepatitis C virusmicro-eliminationmode explorationCOE program
《中国感染控制杂志》 2026 (6)
810-818,9
国家自然科学基金项目(82370635、82570696)
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