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Development of a risk score to guide targeted hepatitis C testing among human immunodeficiency virus patients in Cambodia

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World Journal of Hepatology 2021年第9期13卷 1167-1180页

作者： Anja De Weggheleire Jozefien Buyze sokkab an Sopheak Thai Johan van Griensven Sven Francque Lutgarde Lynen Department of Clinical Sciences Institute of Tropical Medicine AntwerpAntwerp 2000Belgium Infectious Diseases Department Sihanouk Hospital Center of HopePhnom Penh 12101Cambodia Department of Gastroenterology Hepatology Antwerp University HospitalAntwerp 2000Belgium Laboratory of Experimental Medicine and Paediatrics University of AntwerpAntwerp 2000Belgium

BACKGROUND The World Health Organization recommends testing all human immunodeficiency virus(HIV)patients for hepatitis C virus(HCV).In resource-constrained contexts with low-to-intermediate HCV prevalence among HIV patients,as in Cambodia,targeted testing is,in the short-term,potentially more feasible and *** To develop a clinical prediction score(CPS)to risk-stratify HIV patients for HCV coinfection(HCV RNA detected),and derive a decision rule to guide prioritization of HCV testing in settings where‘testing all’is not feasible or unaffordable in the short *** We used data of a cross-sectional HCV diagnostic study in the HIV cohort of Sihanouk Hospital Center of Hope in Phnom *** populations were very rare in this *** development relied on the Spiegelhalter and Knill-Jones *** with an adjusted likelihood ratio≥1.5 or≤0.67 were retained,transformed to natural logarithms,and rounded to integers as score *** performance was evaluated by the area-under-the-ROC curve(AUROC)with 95% confidence intervals(CI),and diagnostic accuracy at the different *** the decision rule,HCV coinfection probability≥1% was agreed as *** Among the 3045 enrolled HIV patients,106 had an HCV *** the 11 candidate predictors(from history-taking,laboratory testing),seven had an adjusted likelihood ratio≥1.5 or≤0.67:≥50 years(+1 point),diabetes mellitus(+1),partner/household member with liver disease(+1),generalized pruritus(+1),platelets<200×10^(9)/L(+1),aspartate transaminase(AST)<30 IU/L(-1),AST-to-platelet ratio index(APRI)≥0.45(+1),and APRI<0.45(-1).The AUROC was 0.84(95%CI:0.80-0.89),indicating good discrimination of HCV/HIV coinfection and HIV *** CPS result≥0 best fits the test-threshold(negative predictive value:99.2%,95%CI:98.8-99.6).Applying this threshold,30%(n=926)would be *** coinfections(15%)would have been missed,none with advanced *** The CPS pe

关键词： Hepatitis C virus Hepatitis C/human immunodeficiency virus coinfection Clinical prediction rule Targeted screening Cambodia Development prediction model

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