Yale Viral Hepatitis Program, Section of Digestive Diseases/Yale Liver Center, Yale University School of Medicine, New Haven, Connecticut, USA.
Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, California, USA.
Am J Gastroenterol. 2020 Sep;115(9):1429-1438. doi: 10.14309/ajg.0000000000000651.
Chronic hepatitis B virus (HBV) infection represents a major global health problem, affecting an estimated 257-291 million persons worldwide and is associated with substantial morbidity and mortality because of clinical complications, such as liver cirrhosis and hepatocellular carcinoma. Despite existing resources for vaccination, screening, and treatment, the burden of chronic HBV remains significant within the United States (US). Both the World Health Organization (WHO) and US Department of Health and Human Services (DHHS) have articulated formal hepatitis elimination plans, although an updated assessment of the epidemiology and prevalence of chronic HBV is needed to inform these initiatives. The Chronic Liver Disease Foundation (CLDF), a nonprofit 501(c)(3) educational organization dedicated to raising awareness of liver disease, partnered with a panel of leading US hepatologists to conduct an updated literature review to develop a contemporary HBV prevalence range estimate. Panel members researched and evaluated the peer-reviewed literature on HBV prevalence and, in May 2019, discussed their findings during a live HBV epidemiology workshop. The panel proposed an overall estimated prevalence for chronic HBV infection in the US of 1.59 million persons (range 1.25-2.49 million). This review provides a summary of the workshop findings and conclusions, which may serve to inform future initiatives focused on HBV screening and prevention in the US.
慢性乙型肝炎病毒(HBV)感染是一个全球性的主要健康问题,据估计全球有 2.57 亿至 2.91 亿人受到感染,并且由于临床并发症(如肝硬化和肝细胞癌)而导致发病率和死亡率较高。尽管存在疫苗接种、筛查和治疗资源,但慢性 HBV 在 美国(US)的负担仍然很大。世界卫生组织(WHO)和美国卫生与公众服务部(DHHS)都制定了正式的消除肝炎计划,尽管需要对慢性 HBV 的流行病学和流行率进行最新评估,以便为这些计划提供信息。非盈利性 501(c)(3)教育组织慢性肝病基金会(CLDF)致力于提高对肝病的认识,与一组美国领先的肝病学家合作,进行了一项更新的文献综述,以制定当代 HBV 流行率范围的估计。小组成员研究和评估了关于 HBV 流行率的同行评议文献,并于 2019 年 5 月在一次现场 HBV 流行病学研讨会上讨论了他们的研究结果。该小组提出了美国慢性 HBV 感染的总体估计流行率为 159 万人(范围为 125 万至 249 万人)。本综述总结了研讨会的研究结果和结论,这可能有助于为未来在美国专注于 HBV 筛查和预防的计划提供信息。