5个大型项目的筛选慢性乙型肝炎在荷兰的中国移民的临床影

StephenW

Liver Int. 2016 Mar 22. doi: 10.1111/liv.13125. [Epub ahead of print]
Clinical impact of five large-scale screening projects for chronic hepatitis B in Chinese migrants in the Netherlands.Coenen S1, van Meer S2, Vrolijk JM1, Richter C3, van Erpecum KJ2, Mostert MC4, Veldhuijzen IK4, Reijnders JG5, van Soest H6, Dirksen K7, Drenth JP8, Koene RP9, Bosschart M10, Friederich P11, Ter Borg MJ12, Daemen RH13, Arends JE14, Verhagen MA15, Schout C16, Spanier BW1.
Author information

• 1Rijnstate Hospital Arnhem, Departments of Gastroenterology and Hepatology, The Netherlands.
• 2University Medical Center Utrecht, Departments of Gastroenterology and Hepatology, The Netherlands.
• 3Rijnstate Hospital Arnhem, Departments of Internal Medicine and Infectious diseases, The Netherlands.
• 4Rotterdam, Departments of Infectious Disease Control, Municipal Health Services, The Netherlands.
• 5Erasmus Medical Center Rotterdam, Departments of Gastroenterology and Hepatology, The Netherlands.
• 6Medical Center Haaglanden The Hague, Departments of Gastroenterology and Hepatology, The Netherlands.
• 7The Hague, Departments of Infectious Disease Control, Municipal Health Services, The Netherlands.
• 8Radboudumc Nijmegen, Departments of Gastroenterology and Hepatology, The Netherlands.
• 9Gelderland Zuid, Departments of Infectious Disease Control, Municipal Health Services, The Netherlands.
• 10Gelderland Midden, Departments of Infectious Disease Control, Municipal Health Services, The Netherlands.
• 11Catharina Hospital Eindhoven, Departments of Gastroenterology and Hepatology, The Netherlands.
• 12Maxima Medical Center Eindhoven, Departments of Gastroenterology and Hepatology, The Netherlands.
• 13Eindhoven, Departments of Infectious Disease Control, Municipal Health Services, The Netherlands.
• 14University Medical Center Utrecht, Departments of Internal Medicine and Infectious diseases, The Netherlands.
• 15Diakonessen Hospital Utrecht, Departments of Gastroenterology and Hepatology, The Netherlands.
• 16Utrecht, Departments of Infectious Disease Control, Municipal Health Services, The Netherlands.
  

AbstractBACKGROUND AND AIMS: In low endemic countries it is debated whether first generation migrants should be screened for chronic hepatitis B infection. We describe the clinical impact of five large-scale Dutch screening projects for hepatitis B in first generation Chinese migrants.
METHODS: Between 2009 and 2013 five independent outreach screening projects for hepatitis B targeting first generation Chinese migrants were conducted in five main Dutch regions. To explore the relevance of our screening we defined clinical impact as the presence of an indication for: 1. antiviral therapy, 2. strict follow-up because of high hepatitis B DNA levels and/or 3. surveillance for hepatocellular carcinoma.
RESULTS: In total, 4423 persons participated in the projects of whom 6.0% (n=264) were HBsAg positive. 129 newly diagnosed HBsAg positive patients were analysed in specialist care. Among these patients prevalence of cirrhosis was 6.9% and antiviral therapy for hepatitis B was started in 32 patients (25%). In patients without a treatment indication, strict follow-up because of high hepatitis B DNA levels and/or surveillance for hepatocellular carcinoma was considered indicated in 64 patients (50%).
CONCLUSIONS: In our screening project in first generation Chinese migrants, antiviral treatment, strict follow-up because of high hepatitis B DNA levels and/or surveillance for hepatocellular carcinoma were considered indicated in three out of four analysed HBsAg positive patients. These data show that detection of hepatitis B in Chinese migrants can have considerable impact on patient care. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.


KEYWORDS: Chinese migrants; Clinical impact; Hepatitis B; Screening; Secondary prevention

StephenW

肝诠释。 2016年22月DOI：10.1111 / liv.13125。 [打印EPUB提前]
的5个大型项目的筛选慢性乙型肝炎在荷兰的中国移民的临床影响。
科嫩S1，面包车米尔S2，Vrolijk JM1，里希特C3，面包车Erpecum KJ2，Mostert MC4，Veldhuijzen IK4，Reijnders JG5，面包车苏斯特H6，德克森K7，Drenth JP8，Koene RP9，Bosschart M10，弗里德里希P11，捷尔博格MJ12，德门RH13，ARENDS JE14，费尔哈亨MA15，Schout C16，斯帕尼尔BW1。
作者信息

    1Rijnstate阿纳姆医院消化内科部门和肝病，荷兰。
    2University医疗中心乌得勒支，消化内科的部门和肝病，荷兰。
    3Rijnstate医院阿纳姆，内科和传染病，荷兰的部门。
    4Rotterdam，传染病防治，市卫生服务，荷兰的部门。
    5Erasmus医学中心的鹿特丹，消化内科的部门和肝病，荷兰。
    6Medical中心Haaglanden海牙，消化内科的部门和肝病，荷兰。
    海牙。第七，传染病防治，市卫生服务，荷兰的部门。
    8Radboudumc奈梅亨，消化内科的部门和肝病，荷兰。
    9Gelderland老城，传染病防治，市卫生服务，荷兰的部门。
    10Gelderland米登，传染病防治，市卫生服务，荷兰的部门。
    11Catharina埃因霍温医院消化内科部门和肝病，荷兰。
    12Maxima医学中心埃因霍温，消化内科的部门和肝病，荷兰。
    13Eindhoven，传染病防治，市卫生服务，荷兰的部门。
    14University医疗中心乌得勒支，内科和传染病，荷兰的部门。
    15Diakonessen乌得勒支医院消化内科部门和肝病，荷兰。
    16Utrecht，传染病防治，市卫生服务，荷兰的部门。

抽象
背景和目的：

在低流行国家，进行辩论第一代移民是否应筛查慢性乙型肝炎病毒感染。我们描述了五个大型荷兰筛查项目，乙肝第一代中国移民的临床影响。
方法：

针对第一代中国移民乙型肝炎之间2009年和2013年的五个独立的外联筛查项目在五个主要的荷兰地区进行。探索我们的筛选的相关性，我们定义了临床影响，作为一个指示的存在：1.抗病毒治疗，2.严格后续因为高乙肝DNA水平和/或3.肝细胞癌监视。
结果：

总共有4423人参与了其中的6.0％（N = 264）为HBsAg阳性的项目。 129新诊断的HBsAg阳性患者在专科护理进行了分析。在这些患者的肝硬化患病率为6.9％，对B型肝炎的抗病毒治疗的32名患者（25％）开始。在患者没有治疗指征，严格随访，因为较高的乙肝DNA水平和/或监察肝细胞癌被认为是64例（50％）表示。
结论：

在我们的第一代中国移民，抗病毒治疗的筛选项目，严格随访，因为较高的乙肝DNA水平和/或监察肝细胞癌被认为是三指出了四个分析HBsAg阳性患者。这些数据表明，在中国移民乙型肝炎检测可以对病人护理相当大的影响。本文由版权保护。版权所有。

本文由版权保护。版权所有。
关键词：

中国移民;临床影响;乙型肝炎;筛选;二级预防