Abstract：Objective To investigate the ability to detect hepatitis C virus antibody (anti-HCV) and hepatitis C virus ribonucleic acid (HCV-RNA) in secondary and tertiary hospitals in Tianjin, and to evaluate the hospitals’ diagnostic capability in combination with the diagnosis Results of physicians. Methods The detection Results of anti-HCV and HCV-RNA in 2014 were obtained from the laboratory records in above-mentioned hospitals in Tianjin in 2015, and the positive rate of anti-HCV as well as the detection rate and positive rate of HCV-RNA were analyzed. The proportional sampling strategy was used to investigate the diagnostic status of hepatitis C infection and related diagnostic evidence in inpatients by reviewing their medical records, and telephone follow-ups were performed in inpatients with unknown information after informed consents were obtained. The diagnostic Results were verified for each inpatient according to the Diagnostic Criteria for Hepatitis C (WS 213-2008) to determine the diagnostic accuracy rate. The basic data of the reported hepatitis C cases were obtained from the Disease Surveillance Information System in 2014. The information of inpatients diagnosed with hepatitis C in the hospitals was matched with that of the reported cases. The reporting rate of hepatitis C cases was analyzed and the adjusted reported incidence rate of hepatitis C was calculated. Results Among the 88 tertiary hospitals in Tianjin in 2014, 80 (90.91%) hospitals had the capacity to detect anti-HCV, of which 22 hospitals had the ability to detect or send out to determine HCV-RNA. The positive rate of anti-HCV in the tertiary hospitals in Tianjin was 1.09%, and the positive rate of anti-HCV was higher in infectious disease hospitals than in non-infectious disease hospitals (1.38% vs. 1.05%, χ2M-H Summary=401.052, P<0.001). 7,129 anti-HCV positive patients were diagnosed by the 22 hospitals with the ability to detect HCV-RNA, with the detection rate and positive rate of HCV-RNA being 15.72% (1,121/7,129) and 77.88% respectively. According to the discharge records of 1,031 anti-HCV positive inpatients, the diagnostic rate of hepatitis C-related diseases was 58.29%. After verifying the diagnoses of hospitalized cases, 953 inpatients were diagnosed with hepatitis C (including inpatients with clinical diagnosis and laboratory-confirmed diagnosis of hepatitis C), and the reported rate of hepatitis C was 31.90% (304/953). The adjusted reported incidence rate of hepatitis C in 2014 was 10.60/100,000, which was 3.13 times that of the actual reported incidence rate. Conclusions The secondary and tertiary hospitals in Tianjin in 2014 had a low proportion of patients undergoing HCV-RNA test to detect viral replication and confirm the diagnosis. The proportions of missed diagnosis and reporting in anti-HCV positive inpatients were high, which significantly affected the accuracy of the reported epidemic data. Therefore, the quality of the reported epidemic data needs further study.
陈静, 王文权, 何海艳, 吴伟慎, 赵莹, 张颖, 霍飞. 天津市医院丙型肝炎检测和诊断能力研究[J]. 实用预防医学, 2018, 25(9): 1071-1074.
CHEN Jing, WANG Wen-quan, HE Hai-yan, WU Wei-shen, ZHAO Ying, ZHANG Ying, HUO Fei. Detection of hepatitis C virus and diagnostic abilityof hepatitis C infection in hospitals in Tianjin. , 2018, 25(9): 1071-1074.
2018, Vol. 25 
