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在香港实现世界卫生组织丙型肝炎控制目标:挑战与策略

Achieving WHO target of HCV control in Hong Kong: challenges and strategies.

作者信息

Wang Yudong, Cheng Gregory, Lau George

机构信息

Humanity and Health Clinical Trial Center, Humanity & Health Medical Group, Hong Kong SAR, China.

Faculty of Health Science, University of Macau, Macau SAR, China.

出版信息

Glob Health Med. 2021 Oct 31;3(5):276-282. doi: 10.35772/ghm.2021.01075.

Abstract

With the introduction of effective directly acting antiviral agents (DAAs) therapy, control and elimination of hepatitis C virus (HCV) infection is becoming a feasible goal. In Hong Kong, HCV prevalence in general population is 0.3%-0.5% over the past decades. However, like other high-income areas/countries, high prevalence of HCV infection has been found in several population groups, such as people who inject drugs (PWID), patients undergoing dialysis, and human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/ AIDS) patients. Based on the epidemiological study using data retrieved from the Hong Kong HCV Registry from January 2005 to March 2017, the estimated territory-wide diagnosis rate and treatment rate of HCV infection were only 50.9% and 12.4%, respectively. Although these rates was comparable to many developed countries/areas, the performances remained substantially below 90% and 80%, the 2030 targets proposed by World Health Organization (WHO). In recognition of the challenges, the Hong Kong Government set up the Steering Committee on Prevention and Control of Viral Hepatitis (SCVH) which formulated the 4. The adopts four key strategies, as described in the WHO framework for global action, namely, awareness, surveillance, prevention and treatment. With the effective implementation of the , especially in targeted screening of high-risk populations and more generalized use of the highly efficacious DAAs for all diagnosed HCV subjects, the goals of reducing HCV transmission and HCV-related morbidity and mortality can be achieved in Hong Kong by 2030.

摘要

随着有效的直接作用抗病毒药物(DAA)疗法的引入,控制和消除丙型肝炎病毒(HCV)感染正成为一个可行的目标。在香港,过去几十年普通人群中HCV的流行率为0.3%-0.5%。然而,与其他高收入地区/国家一样,在一些人群中发现了HCV感染的高流行率,如注射吸毒者(PWID)、接受透析的患者以及人类免疫缺陷病毒感染和获得性免疫缺陷综合征(HIV/AIDS)患者。根据一项利用2005年1月至2017年3月从香港HCV登记处检索的数据进行的流行病学研究,估计全港HCV感染的诊断率和治疗率分别仅为50.9%和12.4%。尽管这些比率与许多发达国家/地区相当,但仍大幅低于世界卫生组织(WHO)提出的2030年目标的90%和80%。认识到这些挑战后,香港政府成立了病毒性肝炎预防及控制督导委员会(SCVH),该委员会制定了4项措施。这些措施采用了4项关键策略,如WHO全球行动框架中所述,即提高认识、监测、预防和治疗。随着这些措施的有效实施,特别是在对高危人群进行针对性筛查以及对所有诊断出的HCV患者更广泛地使用高效DAA方面,到2030年在香港实现减少HCV传播以及与HCV相关的发病率和死亡率的目标是可以实现的。

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