Chronic hepatitis C infection status among HCV-Ab positive patients above 50 years old in Anhui Province from 2004 to 2022.

objectiveTo grasp the current HCV infection status and factors among HCV-Ab positive patients above 50 years old in Anhui Province from 2004 to 2022, and to explore the factors that contribute to the development of CHC.

methodsThis study focuses on patients aged 50 and above who were diagnosed with HCV-Ab positive between 2004 and 2022 in the information system of the Chinese Center for Disease Control and Prevention. The recorded laboratory data (ALT, AST, PLT) were included for subsequent analysis. The overall condition and knowledge level of patients related to hepatitis C were evaluated through a questionnaire survey, and blood samples were collected using nested one-step RT-PCR technology for hepatitis C nucleic acid testing to determine their current infection status. If their HCV antibody test results remained positive for six months or more, they were considered to have CHC. The research subjects were randomly divided into a test set and a validation set in a 7:3 ratio. Lasso regression analysis was then applied to the test set to identify influencing factors, and the robustness of the selected variables in the model was evaluated through ROC curves and statistical indicators. Finally, a multivariate logistic regression model was established with Lasso regression to screen important feature variables as independent variables and CHC infection status as a positive outcome.

resultsA total of 4,558 valid questionnaires were collected. The overall awareness rate regarding the prevention and treatment of hepatitis C was 25.87%, with 1,196 participants (26.24%) testing positive for HCV RNA, and were recorded as CHC patients. The study revealed a statistically significant difference in HCV RNA positivity rates between those who had previously received antiviral therapy and those who had not (χ² = 490.65, P < 0.001). The results of the model, including variables selected by LASSO regression, show an AUC of 0.798 (95% CI: 0.750 ~ 0.805), a sensitivity of 0.685, a specificity of 0.780, a precision of 0.518, and an F1 score of 0.590. Logistic regression showed that subjects who were female (OR = 0.639, 95% CI: 0.547 ~ 0.746), located in the northern region of Anhui Province (OR = 0.551, 95% CI: 0.464 ~ 0.653), and had received antiviral treatment (OR = 0.138, 95% CI: 0.112 ~ 0.171) were at a lower probability of developing CHC.

conclusionsA high prevalence of CHC infection was observed in Anhui Province, whereas awareness and antiviral treatment rates were low among individuals aged ≥ 50 years with previous hepatitis C. Health education should be strengthened to promote HCV RNA screening and antiviral treatment, especially for male patients in southern Anhui who are not receiving antiviral therapy and have elevated AST levels. CLINICAL TRIAL NUMBER: Not applicable.