Enhancing Traditional Surveillance Methods to Assess the Comorbidities and Complications of Hepatitis C Infection in a Large City in the United States.

摘要

Hepatitis C virus (HCV) has infected approximately 400,000 residents of a large southwestern US state. Yet, despite its impact, the knowledge of the epidemiological and clinical characteristics of HCV infection needed to target prevention strategies in this state is scarce. The purpose of this quantitative, cross-sectional study was to elucidate the comorbidities, demographic characteristics, and risk factors of HCV infection in residents of a large southwestern US state. The study used the proximate determinants framework to generate an understanding of the context of the spread of hepatitis C. A probability proportional to size (PPS) sampling method was used to obtain a representative sample of cases of HCV infection in this area. The most prevalent comorbidities and risk factors for HCV infection in this population were selected in the univariate analysis. Bivariate analysis using Chi-square tests were used to test associations between comorbidities (hypertension, diabetes and renal disease) and selected risk factors. Finally, the association between all comorbidities and risk factors selected in the bivariate analysis were assessed in a multivariate analysis. Hypertension was associated with liver transplant (chi2 = 3.75; p = 0.05). Renal disease was significantly associated with mortality in HCV patients (chi 2 = 6.842; p = 0.008) and race/ethnicity (chi2 = 9.78; p = 0.021). In the multivariate analysis, all comorbidities were significantly associated with age over 50 years and IV drug use among persons with HCV infection. Implications for positive social change include the development of tailored hepatitis C prevention programs that may result reduced HCV disease transmission.