Title : Analysis of influencing factors enrollment in antiviral therapy among previously reported hepatitis c cases in Kunming city
Abstract:
Objective: To understand the basic characteristics and the factors influencing enrollment in antiviral therapy among previously reported hepatitis C (HCV) cases in Kunming City.
Methods: This study enrolled previously reported HCV cases under follow-up in Kunming City. Participants were divided into two groups: those who were currently or had previously received antiviral treatment, and those who had never received treatment. A face-to-face survey was conducted to collect information on general demographic characteristics, relevant disease history, high-risk behaviors, and HCV knowledge. Data were linked with the HCV epidemic database. Descriptive statistics were used to summarize the basic information of the subjects. Univariate and multivariate unconditional logistic regression models were employed to analyze the influencing factors.
Results: Among the 4090 study subjects, 1777 (43.4%) were currently or had previously received antiviral treatment, while 2313 (56.6%) had never been enrolled. There were 2446 males (59.8%) and 1644 females (40.2%). The majority were aged 45-54 years (46.7%), had a junior high school education level (41.9%), and were married (66.1%). Most had urban resident-based medical insurance (72.9%). The primary healthcare facilities visited were public municipal-level (40.0%) and county/district-level hospitals (27.6%). Over half were knowledgeable about HCV (57.3%). The main occupations were farmer (34.7%) and unemployed (31.8%). Multivariate analysis indicated that being male (OR=1.23, 95% CI: 1.05-1.44), permanent residency in Kunming City (OR=1.58, 95% CI: 1.35-1.87), monthly income of 1000-3000 RMB (OR=1.24, 95% CI: 1.02-1.50) or >3000 RMB (OR=1.48, 95% CI: 1.16-1.89), having HCV knowledge (OR=1.46, 95% CI: 1.24-1.72), and being an enterprise employee (OR=1.91, 95% CI: 1.33-2.73) were promoting factors for treatment enrollment. Conversely, residency in other cities within the province (OR=0.93, 95% CI: 0.39-2.21), having genotype 3b (OR=0.14, 95% CI: 0.11-0.18) or other genotype (OR=0.13, 95% CI: 0.11-0.16), having no health insurance (OR=0.16, 95% CI: 0.08-0.33), and receiving care at county-level hospitals (OR=0.68, 95% CI: 0.53-0.87), community health centers/township hospitals (OR=0.53, 95% CI: 0.36-0.78), or private hospitals (OR=0.67, 95% CI: 0.47-0.96) were limiting factors for treatment enrollment.
Conclusion: The proportion of previously reported HCV cases in Kunming City enrolled in antiviral treatment is not high. To enhance the referral and enrollment of HCV patients into antiviral treatment, targeted interventions and treatment measures should be implemented for patients with different characteristics.
Keywords: Hepatitis C; Antiviral Therapy; Influencing Factors
