Velosa José, Macedo Guilherme
Gastroenterology Department, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.
Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
GE Port J Gastroenterol. 2020 Apr;27(3):166-171. doi: 10.1159/000505582. Epub 2020 Feb 7.
The burden of hepatitis C virus infection remains very high despite huge progress in the cure of the infection. The high prevalence of hepatitis C, especially in vulnerable groups and particularly drug users, may compromise the achievement of the 2030 WHO targets with a 90% reduction in new infections and a 65% reduction in mortality. Therapy with the latest pangenotypic direct-acting antivirals provides cure rates in the order of 97% with short-term oral treatment (8-12 weeks) and with an excellent safety and tolerability profile. Curing the infection causes significant health gains derived from preventing complications from cirrhosis, especially hepatocellular carcinoma, and from liver transplantation. Elimination of hepatitis seems feasible with the implementation of a massive therapy program, focusing particularly on vulnerable populations, through micro-elimination strategies, and in the general population with age-based screening. The reduction of the virus reservoir (humans are the only reservoir) is a determining factor in eradicating the virus.
尽管丙型肝炎病毒感染的治愈取得了巨大进展，但其感染负担仍然非常高。丙型肝炎的高流行率，尤其是在弱势群体特别是吸毒者中，可能会影响世界卫生组织2030年目标的实现，即新感染减少90%，死亡率降低65%。使用最新的泛基因型直接抗病毒药物进行治疗，短期口服治疗（8 - 12周）的治愈率可达97%左右，且安全性和耐受性良好。治愈感染可带来显著的健康益处，包括预防肝硬化并发症，尤其是肝细胞癌，以及肝移植相关的并发症。通过实施大规模治疗计划，特别是针对弱势群体采用微消除策略，并在普通人群中进行基于年龄的筛查，消除丙型肝炎似乎是可行的。减少病毒储存库（人类是唯一的储存库）是根除该病毒的决定性因素。
