Graham Camilla S, Swan Tracy
Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States.
Treatment Action Group, New York, NY, United States.
Antiviral Res. 2015 Jul;119:89-96. doi: 10.1016/j.antiviral.2015.01.004. Epub 2015 Jan 20.
We are entering a new era in the treatment of hepatitis C virus (HCV) infection and almost all patient groups in high-income countries have the potential to be cured with all-oral, highly potent combinations of direct-acting antiviral drugs. Soon the main barrier to curing hepatitis C, even in wealthy countries, will be the high price of these all-oral regimens. The gulf between the advances in HCV drug development and access to treatment for individual patients will be even greater in low- and middle-income countries (LMIC) where 80% of the global burden of HCV infection and mortality exists. Ensuring that people in LMIC have access to regimens against HCV will require a similar level of advocacy and public-private partnerships as has transformed the control of other global diseases such as HIV. Numerous challenges will need to be overcome. These include improving low-cost diagnostic tests, especially in sub-Saharan Africa where the false-positive rate is unacceptably high, reducing iatrogenic spread of HCV, addressing transmission among people who inject drugs (PWID), and ensuring affordable access to antiviral treatment for all people living with HCV infection in LMIC. This article forms part of a symposium in Antiviral Research on "Hepatitis C: next steps toward global eradication."
我们正在进入丙型肝炎病毒（HCV）感染治疗的新时代，高收入国家几乎所有患者群体都有潜力通过全口服、高效的直接抗病毒药物组合治愈。很快，即使在富裕国家，治愈丙型肝炎的主要障碍也将是这些全口服治疗方案的高昂价格。在低收入和中等收入国家（LMIC），丙型肝炎病毒感染和死亡的全球负担有80%存在，HCV药物开发的进展与个体患者获得治疗之间的差距将更大。确保LMIC的人们能够获得抗HCV治疗方案，将需要与推动控制其他全球疾病（如HIV）类似程度的宣传和公私伙伴关系。需要克服众多挑战。这些挑战包括改进低成本诊断测试，特别是在撒哈拉以南非洲，那里的假阳性率高得令人无法接受；减少HCV的医源性传播；解决注射吸毒者（PWID）之间的传播问题；以及确保LMIC所有HCV感染者都能负担得起抗病毒治疗。本文是《抗病毒研究》中关于“丙型肝炎：迈向全球根除的下一步”研讨会的一部分。
