Rizzetto Mario, Hamid Saeed, Negro Franco
Department of Medical Sciences, University of Turin, Turin, Italy.
Department of Medicine, The Aga Khan University, Karachi, Pakistan.
J Hepatol. 2021 May;74(5):1200-1211. doi: 10.1016/j.jhep.2021.01.014. Epub 2021 Jan 20.
The global epidemiology of hepatitis D is changing with the widespread implementation of vaccination against hepatitis B. In high-income countries that achieved optimal control of HBV, the epidemiology of hepatitis D is dual, consisting of an ageing cohort of domestic patients with advanced liver fibrosis who represent the end stage of the natural history of HDV, and of a younger generation of immigrants from endemic countries who account for the majority of new infections. As observed in Europe in the 1980s, the distinctive clinical characteristic of chronic hepatitis D in endemic countries is the accelerated progression to cirrhosis and hepatocellular carcinoma. Despite some recent progress, the therapeutic management of HDV remains unsatisfactory, as most patients are not cured of HDV with currently available medicines. This review article describes the current epidemiology and clinical features of chronic hepatitis D, based on the literature published in the last 10 years.
随着乙肝疫苗的广泛接种，丁型肝炎的全球流行病学正在发生变化。在实现了乙肝最佳控制的高收入国家，丁型肝炎的流行病学呈现出双重特征，一方面是国内患有晚期肝纤维化的老年患者群体，他们代表了丁型肝炎病毒自然史的终末期；另一方面是来自流行国家的年轻移民一代，他们占新感染病例的大多数。正如20世纪80年代在欧洲所观察到的那样，流行国家慢性丁型肝炎的独特临床特征是向肝硬化和肝细胞癌的加速进展。尽管最近取得了一些进展，但丁型肝炎的治疗管理仍然不尽人意，因为目前大多数患者无法用现有药物治愈丁型肝炎。这篇综述文章基于过去10年发表的文献，描述了慢性丁型肝炎的当前流行病学和临床特征。
