Cooper Curtis L, Mills Edward, Wabwire Ben O, Ford Nathan, Olupot-Olupot Peter
University of Ottawa Division of Infectious Diseases, Room G12, The Ottawa Hospital-General Campus, 501 Smyth Road, Ottawa, Ontario, Canada K1H 8L6.
Int J Infect Dis. 2009 May;13(3):302-6. doi: 10.1016/j.ijid.2008.06.042. Epub 2008 Nov 11.
There is a heavy burden of HIV-hepatitis B virus (HBV) and HIV-hepatitis C virus (HCV) co-infection in many regions of the developing world. An often unmentioned illness, issues of poverty, socio-economic status, nutrition, access to medical care, and mistrust of Western-style medicine conspire to reduce the opportunity to receive clinical work-up and treatment for chronic viral hepatitis. We discuss key issues specific to the treatment of viral hepatitis and obstacles to success with this endeavor in the context of HIV co-infection in Africa. We predict that provision of viral hepatitis antiviral therapy will become a more pressing issue as more HIV-infected patients receive lifesaving combination antiretroviral therapy only to succumb thereafter from viral hepatitis-induced liver disease. Given the lessons learned from combination antiretroviral rollout in sub-Saharan Africa, establishing expertise and infrastructure for viral hepatitis care and antiviral therapy is relevant. Failure to act now may diminish the milestones and the gains made with antiretroviral therapy in the developing world.
在发展中世界的许多地区，艾滋病毒与乙型肝炎病毒（HBV）以及艾滋病毒与丙型肝炎病毒（HCV）合并感染的负担很重。一种常常未被提及的疾病、贫困问题、社会经济地位、营养状况、获得医疗服务的机会以及对西医的不信任，共同导致接受慢性病毒性肝炎临床检查和治疗的机会减少。我们在非洲艾滋病毒合并感染的背景下，讨论病毒性肝炎治疗的关键问题以及这项工作取得成功的障碍。我们预测，随着越来越多的艾滋病毒感染患者接受挽救生命的联合抗逆转录病毒疗法，却随后死于病毒性肝炎引发的肝病，提供病毒性肝炎抗病毒治疗将成为一个更加紧迫的问题。鉴于从撒哈拉以南非洲推广联合抗逆转录病毒疗法中吸取的经验教训，建立病毒性肝炎护理和抗病毒治疗的专业知识及基础设施很有必要。现在不采取行动可能会削弱发展中世界在抗逆转录病毒疗法方面取得的里程碑式成果和进展。
