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将 MAFLD 视为全球丙型肝炎消除工作的一部分:国际视角。

MAFLD considerations as a part of the global hepatitis C elimination effort: an international perspective.

机构信息

Minia, Egypt.

Barcelona, Spain.

出版信息

Aliment Pharmacol Ther. 2021 May;53(10):1080-1089. doi: 10.1111/apt.16346. Epub 2021 Mar 22.

Abstract

BACKGROUND

The World Health Organization (WHO) set a goal to eliminate hepatitis C (HCV) infection globally by 2030, with specific targets to reduce new viral hepatitis infections by 80% and reduce related deaths by 65%. However, an overlooked aspect that may hinder these efforts is the impact other liver diseases could have by continuing to drive liver disease progression and offset the beneficial impact of DAAs on end-stage liver disease and hepatocellular carcinoma (HCC). In particular, the decrease in HCV prevalence has been countered by a marked increase in the prevalence of metabolic-associated fatty liver disease (MAFLD).

AIMS

To review the potential interaction of HCV and MAFLD.

METHODS

We have reviewed the literature relating to an arrange of interaction of HCV, metabolic dysfunction and MAFLD.

RESULTS

In this viewpoint, international experts suggest a holistic and multidisciplinary approach for the management of the growing number of treated HCV patients who achieved SVR, taking into consideration the overlooked impact of MAFLD for reducing morbidity and mortality in people who have had HCV.

CONCLUSIONS

This will strengthen and improve the continuum of care cascade for patients with liver disease(s) and holds the potential to alleviate the cost burden of disease; and increase quality of life for patients following DAAs treatment.

摘要

背景

世界卫生组织(WHO)设定了到 2030 年在全球消除丙型肝炎(HCV)感染的目标,具体目标是将新的病毒性肝炎感染减少 80%,相关死亡减少 65%。然而,一个被忽视的方面可能会阻碍这些努力,那就是其他肝脏疾病的影响,这些疾病可能会继续推动肝脏疾病的进展,并抵消直接抗病毒药物(DAAs)对终末期肝病和肝细胞癌(HCC)的有益影响。特别是,丙型肝炎流行率的下降被代谢相关脂肪性肝病(MAFLD)流行率的显著上升所抵消。

目的

综述丙型肝炎和 MAFLD 之间可能存在的相互作用。

方法

我们回顾了与丙型肝炎、代谢功能障碍和 MAFLD 之间各种相互作用相关的文献。

结果

在这篇观点文章中,国际专家建议采取整体和多学科的方法来管理越来越多的接受治疗的丙型肝炎病毒患者,这些患者已经实现了持续病毒学应答,同时考虑到 MAFLD 对降低已感染丙型肝炎病毒患者的发病率和死亡率的忽视影响。

结论

这将加强和改善肝病患者的连续护理链,并有可能减轻疾病的成本负担;并提高 DAAs 治疗后患者的生活质量。

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