由新北市健康篩檢資料估計全國各鄉鎮居民C型肝炎病毒抗體盛行率

Estimating the Seroprevalence of Hepatitis C Virus Infection in Taiwan Validated by Health Screening Data from New Taipei City

利用全民健保資料庫估計全國各鄉鎮區 C型肝炎病毒抗體盛行率。以2005-2008 年新北市健康篩 检資料為驗證資料；針對參加新北市篩檢C型肝炎病毒抗體陽性民眾，藉由共參加篩檢後健保資料中相 關診斷，找出最佳估計C型肝炎抗體盛行率之診斷代碼組合，用以推估全國C型肝炎抗體陽性人數；進 一步配合投保對象居住地歸屬模型，以全民健康保險資料庫估算 2013年全國各縣市鄉鎮C型肝炎病毒抗 體之盛行率。參加新北市健康篩檢有 136.290 位民眾，其中C型肝炎病毒抗體陽性者有4.122 人（3.02%）。 以最佳估計C型肝炎抗體盛行率之診斷代碼組合應用於全國健保資料，2015年全國C型肝炎病毒抗體陽 性總人數約9萬人，盛行率為3.22%，男性（3.49%）略高於女性（2.96%），年齡層以40 歲以下最低（1.02%）， 隨著年紀盛行率上升至70-79 歲最高（7.81%），且地區差異性大（1.14-13.6%）；全國各鄉鎮區 C型肝炎病毒 抗體盛行率最高者分別為：苗栗大湖鄉、雲林褒忠鄉、雲林大埤鄉、雲林臺西鄉及嘉義六腳鄉。國內不 同鄉鎮區 C型肝炎病毒抗體盛行率有相當大的差異。

To investigate the seroprevalence of hepatitis C virus (HCV) infection in Taiwan townships using the National Health Insurance Database (NHIRD). We used the 2005-2008 New Taipei City health screening data as validation data; the ICD-9 (International Classification of Diseases, 9th revision) diagnostic codes for hepatitis in outpatient and inpatient records after screening were extracted among participants with positive anti-HCV antibody after linkage with the NHIRD; and the combination of diagnostic codes that most precisely estimate the seroprevalence of HCV, along with information on insurers' place of residence, was used to evaluate the seroprevalence of HCV infection in Taiwan Township. A total of 136,290 individuals participated in the New Taipei City health screening service and 4122 (3.02%) were positive for anti-HCV antibody. With the appliance of the combination of diagnostic codes on NHIRD, approximately 690 thousand individuals had been infected with HCV in 2015, accounting for 3.22% of all population. The prevalence was higher in men (3.49% in men vs. 2.96% in women), increased with age and had substantial geographic variation (1.14-13.6%). The townships with highest prevalence for HCV infection included Dahu Township in Miaoli County, Baozhong Township in Yunlin County, Dapi Township in Yunlin County, Taixi Township in Yunlin County and Liujiao Township in Chiayi County. There was a great geographic variation in seroprevalence of HCV infection in Taiwan township.