Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
J Viral Hepat. 2014 May;21 Suppl 1:60-89. doi: 10.1111/jvh.12249.
The number of hepatitis C virus (HCV) infections is projected to decline while those with advanced liver disease will increase. A modeling approach was used to forecast two treatment scenarios: (i) the impact of increased treatment efficacy while keeping the number of treated patients constant and (ii) increasing efficacy and treatment rate. This analysis suggests that successful diagnosis and treatment of a small proportion of patients can contribute significantly to the reduction of disease burden in the countries studied. The largest reduction in HCV-related morbidity and mortality occurs when increased treatment is combined with higher efficacy therapies, generally in combination with increased diagnosis. With a treatment rate of approximately 10%, this analysis suggests it is possible to achieve elimination of HCV (defined as a >90% decline in total infections by 2030). However, for most countries presented, this will require a 3-5 fold increase in diagnosis and/or treatment. Thus, building the public health and clinical provider capacity for improved diagnosis and treatment will be critical.
丙型肝炎病毒 (HCV) 感染人数预计将下降，而患有晚期肝病的人数将会增加。采用建模方法预测了两种治疗方案：(i) 在保持治疗患者数量不变的情况下提高治疗效果，以及 (ii) 提高疗效和治疗率。这项分析表明，成功诊断和治疗一小部分患者可以显著降低研究国家的疾病负担。当增加治疗与更高疗效的治疗方法相结合时，通常与增加诊断相结合，丙型肝炎相关发病率和死亡率的降幅最大。在治疗率约为 10%的情况下，本分析表明有可能实现 HCV 的消除（到 2030 年，总感染人数下降>90%）。然而，对于大多数呈现的国家来说，这将需要诊断和/或治疗的 3-5 倍增加。因此，建立公共卫生和临床提供者改善诊断和治疗的能力将是至关重要的。
