凱特琳·斯圖爾平  / 2024/01/23  / Healio

事實由 Carol L. DiBerardino（MLA、ELS）核實

要點：

• HIV、HBV 和HCV 的三重檢測將為每個HIV 病例額外識別出5 個HBV 病例和3 個HCV 病例。

•檢測所有三種病毒比僅檢測 HIV 多花費不到 2 美元。

研究人員表示，研究結果顯示，世衛組織針對愛滋病毒、B型肝炎和C型肝炎的三重檢測活動應擴大，而不僅僅是針對世衛組織列出的高危險群。

「這項研究是由於愛滋病毒、B型肝炎和C型肝炎診斷和治療的巨大差異而進行的」，倫敦帝國學院醫學生 Natasha Beard 博士告訴 Healio。「雖然 85% 的愛滋病毒感染者得到診斷，但只有 10.5% 的B型肝炎感染者和 21% 的C型肝炎感染者得到診斷。同樣，75% 的愛滋病毒感染者正在接受治療，但只有 2.2% 的B型肝炎感染者和 21% 的C型肝炎感染者正在接受治療。”

她補充說，「因此，預計到 2040 年，病毒性肝炎每年導致的死亡人數將超過愛滋病毒、瘧疾和結核病流行病死亡人數的總和」。

Beard 和利物浦大學藥理學系高級客座研究員Andrew Hill 醫學博士進行了一項系統性回顧，評估了九個不同人群中HIV、HBV 和HCV 的盛行率，包括捐血者、一般人群、醫療保健人員、患有愛滋病的個人無家可歸者、男男性行為者、吸毒者、孕婦、囚犯和難民，為世衛組織新的三重檢測運動提供理由。

作者解釋說，該活動包括世界衛生組織建議對吸毒者、男男性行為者和囚犯進行三重檢測的指南，該活動將於 2022 年推出。

Beard 和 Hill 搜尋了 MEDLINE、Embase 和 Global Health，以找出 2013 年 1 月 1 日至 2023 年 2 月 24 日期間發表的論文。納入的論文報告了 HIV、HBV 和 HCV 的流行情況。

總共納入了 175 項研究，對超過 1400 萬人進行了抽樣調查。 HIV的平均盛行率為0.22%，HBV為1.09%，HCV為0.65%，而至少一種血液傳染病毒檢測呈陽性的平均人數為1.9%。

根據這些數字，Beard 和 Hill 確定，透過三重檢測，每發現一個 HIV 病例，就有 5 例被診斷為 。HBV 感染，3 例被診斷為 HCV 感染。 他們還表示，三重檢測的成本不會太高，因為所有三種病毒的檢測費用為 2.48 美元，而價格最低的單獨 HIV 檢測的平均成本為 1.00 美元。

他們寫道，這些數據為將愛滋病毒檢測範圍擴大到所有人群而不僅僅是世衛組織建議的危險人群提供了三重檢測的理由。

「這篇文章的主要訊息是，我們應該以現有成功的愛滋病毒診斷途徑為基礎，並將其擴展至B型和C型肝炎的檢測和治療」，比爾德說。「永續發展目標旨在到 2030 年對抗這三種病毒，因此不能低估對這三種病毒實施廣泛且低成本的診斷和治療途徑的必要性」。

文獻來源：

Beard N, et al.《 感染症開放論壇》。 2024；doi：10.1093/ofid/ofad666。

揭露：作者報告沒有相關的財務揭露。

Triple testing for HIV, HBV, HCV at once would help identify more cases across populations

Caitlyn Stulpin  / January 23, 2024 / Healio

Fact checked by Carol L. DiBerardino, MLA, ELS

Key takeaways:

• Triple testing for HIV, HBV and HCV would identify an additional five HBV and three HCV cases for each HIV case.
• It would cost less than $2 more to test for all three viruses as opposed to just HIV.

Study results suggest that WHO’s triple testing campaign for HIV, hepatitis B and hepatitis C should be expanded and not just target the three groups WHO listed to be most at risk, researchers said.

“This study was prompted by the vast differences in HIV and hepatitis B and hepatitis C diagnoses and treatment,” Natasha Beard, BSc, medical student at the Imperial College London, told Healio. “Whilst 85% of people living with HIV have been diagnosed, only 10.5% of people living with hepatitis B and 21% of people living with hepatitis C have received diagnoses. Similarly, 75% of people living with HIV are receiving treatment, yet only 2.2% of people living with hepatitis B and 21% of people living with hepatitis C are receiving treatments.”

Beard N, et al. Open Forum Infect Dis. 2024;doi:10.1093/ofid/ofad666.

She added that, “as a result, it is estimated that by 2040, viral hepatitis will result in more deaths annually than the HIV, malaria, and tuberculosis epidemics combined.”

Beard and Andrew Hill, MD, senior visiting Research Fellow in the Pharmacology Department at Liverpool University, conducted a systematic review assessing the prevalence of HIV, HBV and HCV in nine different population groups including blood donors, general population, health care attendees, individuals experiencing homelessness, men who have sex with men (MSM), people who use drugs, pregnant people, prisoners and refugees, to provide justification for the WHO’s new triple testing campaign.

The campaign, which the authors explained consists of guidelines from WHO recommending triple testing for people who use drugs, MSM and prisoners, was introduced to 2022.

Beard and Hill searched MEDLINE, Embase and Global Health to identify papers published between Jan. 1, 2013, and Feb. 24, 2023. Papers that were included reported the prevalence of HIV, HBV and HCV.

In total, 175 studies sampling over 14 million people were included. The average prevalence of HIV was 0.22%, HBV was 1.09% and HCV was 0.65%, whereas the average number of people who tested positive for at least one blood-borne virus was 1.9%.

Based on these numbers, Beard and Hill determined that through triple testing, for every case of HIV identified, five would be diagnosed with HBV and three with HCV. They also said that triple testing would not be too costly because testing for all three viruses is available for $2.48 compared with the average cost of $1.00 for the lowest-priced isolated HIV test.

They wrote that these data provide justification for the expansion from HIV to triple testing to all groups, not just WHO’s recommended risk groups.

“The take-home message from this article is that we should build on the pre-existing successful HIV diagnostic pathway and expand this to incorporate testing and treatment for hepatitis B and C,” Beard said. “With the Sustainable Development Goals aiming to combat these three viruses by 2030, the necessity of implementing widespread and low-cost diagnostic and treatment pathways for these three viruses cannot be understated.”

Source: 

Beard N, et al. Open Forum Infect Dis. 2024;doi:10.1093/ofid/ofad666.

Disclosures: The authors report no relevant financial disclosures.