【摘要】 目的 分析浙江省丙型病毒性肝炎（丙肝）病例直接抗病毒药物（DAA）治疗的影响因素，为优化本地区丙肝防治策略、提高DAA治疗覆盖率提供依据。方法 选择浙江省8个县（市、区）为现场调查点，采用连续抽样方法抽取2022年11月—2024年6月报告的丙肝确诊病例，通过问卷调查收集人口学信息、诊疗情况、DAA治疗及相关医保政策认知等资料；采用多因素logistic回归模型分析丙肝病例DAA治疗的影响因素。结果 发放问卷412份，回收有效问卷404份，问卷有效率为98.06%。男性291例，占72.03%；女性113例，占27.97%。年龄M(Q_R)为49.00(11.00)岁。DAA治疗303例，治疗比例为75.00%。多因素logistic回归分析结果显示，40～<50岁（OR=3.469,95%CI:1.228～9.345）和家庭人均月收入>3 000元（>3 000～5 000元，OR=3.198,95%CI:1.597～6.403;>5 000元，OR=5.391,95%CI:2.230～13.033）的丙肝病例DAA治疗可能性较高；非感染科确诊（OR=0.334,95%CI:0.173～0.643）、关注DAA治疗经济负担（OR=0.309,95%CI:0.160～0.599）和不知晓丙肝按病种支付政策（OR=0.262,95%CI:0.111～0.622）的丙肝病例DAA治疗可能性较低。结论 浙江省丙肝病例DAA治疗比例较高，年龄、家庭人均月收入、确诊科室、DAA治疗关注因素和医保/支付政策影响丙肝病例DAA治疗。更多还原

【Abstract】 ObjectiveTo analyze the factors affecting direct-acting antiviral(DAA) therapy among cases with hepatitis C virus(HCV) infection in Zhejiang Province, so as to provide evidence for optimizing local HCV prevention and treatment strategies and improving DAA treatment coverage.MethodsEight counties(cities, districts) in Zhejiang Province were selected as survey sites. Consecutive sampling was used to enroll HCV cases reported from November 2022 to June 2024. Demographic information, diagnosis and treatment status, DAA therapy, and awareness of relevant medical insurance policies were collected through questionnaire surveys. Factors affecting DAA therapy among cases with HCV infection were analyzed using a multivariable logistic regression model.ResultsA total of 412 questionnaires were distributed, and 404 valid questionnaires were collected, with an effective rate of 98.06%. There were 291 males(72.03%)and 113 females(27.97%). The median age was 49.00(interquartile range, 11.00) years. A total of 303 cases received DAA therapy, with a proportion of 75.00%. Multivariable logistic regression analysis showed that HCV cases aged 40-<50 years(OR=3.469, 95%CI: 1.228-9.345) and with per capita monthly household income >3 000 yuan(>3 000-5 000 yuan, OR=3.198, 95%CI: 1.597-6.403; >5 000 yuan, OR=5.391, 95%CI: 2.230-13.033) had higher likelihood of receiving DAA therapy. HCV cases diagnosed in non-infectious disease departments(OR=0.334, 95%CI: 0.173-0.643), concerned about economic burden of DAA therapy(OR=0.309, 95%CI: 0.160-0.599), and unaware of HCV payment policy by disease type(OR=0.262, 95%CI: 0.111-0.622) had lower likelihood of receiving DAA therapy.ConclusionsThe proportion of DAA therapy among cases with HCV infection in Zhejiang Province is relatively high. Age, per capita monthly household income, department of diagnosis, concerns about DAA therapy, and medical insurance/payment policies are factors influencing DAA therapy among cases with HCV infection.更多还原