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丙型肝炎病毒疾病诊断、预防及管理的循证共识

Evidence-based consensus on the diagnosis, prevention and management of hepatitis C virus disease.

作者信息

Shaheen Mahrukh Akbar, Idrees Muhammad

机构信息

Mahrukh Akbar Shaheen, Muhammad Idrees, Division of Molecular Virology, National Centre of Excellence in Molecular Biology, University of the Punjab, Lahore 53700, Pakistan.

出版信息

World J Hepatol. 2015 Mar 27;7(3):616-27. doi: 10.4254/wjh.v7.i3.616.

Abstract

Hepatitis C virus (HCV) is a potent human pathogen and is one of the main causes of chronic hepatitis round the world. The present review describes the evidence-based consensus on the diagnosis, prevention and management of HCV disease. Various techniques, for the detection of anti-HCV immunoglobulin G immunoassays, detection of HCV RNA by identifying virus-specific molecules nucleic acid testings, recognition of core antigen for diagnosis of HCV, quantitative antigen assay, have been used to detect HCV RNA and core antigen. Advanced technologies such as nanoparticle-based diagnostic assays, loop-mediated isothermal amplification and aptamers and Ortho trak-C assay have also come to the front that provides best detection results with greater ease and specificity for detection of HCV. It is of immense importance to prevent this infection especially among the sexual partners, injecting drug users, mother-to-infant transmission of HCV, household contact, healthcare workers and people who get tattoos and piercing on their skin. Management of this infection is intended to eradicate it out of the body of patients. Management includes examining the treatment (efficacy and protection), assessment of hepatic condition before commencing therapy, controlling the parameters upon which dual and triple therapies work, monitoring the body after treatment and adjusting the co-factors. Examining the treatment in some special groups of people (HIV/HCV co-infected, hemodialysis patients, renal transplanted patients).

摘要

丙型肝炎病毒(HCV)是一种强大的人类病原体,是全球慢性肝炎的主要病因之一。本综述描述了关于丙型肝炎疾病诊断、预防和管理的循证共识。已使用多种技术来检测HCV,包括抗HCV免疫球蛋白G免疫测定、通过鉴定病毒特异性分子核酸检测来检测HCV RNA、识别用于诊断HCV的核心抗原、定量抗原测定等。基于纳米颗粒的诊断测定、环介导等温扩增、适体和Ortho trak-C测定等先进技术也已崭露头角,它们能更轻松、更特异地产出最佳检测结果以检测HCV。预防这种感染极为重要,尤其是在性伴侣、注射吸毒者、HCV母婴传播、家庭接触者、医护人员以及有纹身和皮肤穿刺的人群中。对这种感染的管理旨在将其从患者体内根除。管理措施包括检查治疗(疗效和安全性)、在开始治疗前评估肝脏状况、控制双重和三重疗法所依据的参数、治疗后监测身体状况以及调整辅助因素。还要在一些特殊人群(HIV/HCV合并感染、血液透析患者、肾移植患者)中检查治疗情况。

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