Spearman C W
Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
S Afr Med J. 2018 Aug 8;108(8b):13-16. doi: 10.7196/SAMJ.2018.v108i8b.13496.
Hepatitis B (HBV) remains a global health problem despite the availability of effective vaccines since 1982 and effective antiviral therapy. The global burden of disease is substantial, with HBV resulting in 887 220 deaths in 2015: acute hepatitis (87 076), cirrhosis (462 690) and hepatocellular carcinoma (337 454). The World Health Organization has a vision to eliminate viral hepatitis as a public health threat by 2030. Although HBV and its associated complications of cirrhosis, liver failure and hepatocellular carcinoma are entirely vaccine preventable, there is no cure for chronic hepatitis B as yet. HBV elimination strategies will need to focus on effective and implementable preventive and therapeutic strategies such as upscaling HBV birth-dose vaccination, full HBV vaccine coverage, vaccination of high-risk groups, prevention of mother-to-child transmission, and identification of HBV-infected individuals and linkage to care with sustainable access to antiviral therapy.
尽管自1982年以来已有有效的疫苗和有效的抗病毒疗法,但乙型肝炎(HBV)仍然是一个全球性的健康问题。疾病的全球负担相当大,2015年HBV导致887220人死亡:急性肝炎(87076人)、肝硬化(462690人)和肝细胞癌(337454人)。世界卫生组织的愿景是到2030年消除病毒性肝炎对公共卫生的威胁。虽然HBV及其相关的肝硬化、肝衰竭和肝细胞癌并发症完全可以通过疫苗预防,但慢性乙型肝炎目前仍无法治愈。HBV消除策略需要侧重于有效且可实施的预防和治疗策略,例如扩大HBV出生剂量疫苗接种、实现HBV疫苗全面覆盖、对高危人群进行疫苗接种、预防母婴传播,以及识别HBV感染个体并将其与可持续获得抗病毒治疗的护理联系起来。