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全球丙型肝炎的流行率、基因型分布和治疗。

Worldwide prevalence, genotype distribution and management of hepatitis C.

机构信息

Division of Clinical and Translational Research, Larkin Community Hospital, South Miami, Florida, United States of America.

Department of Biomedical Sciences and Human Oncology, Unit of Internal Medicine and Clinical Oncology, University of Bari "Aldo Moro", 70124 Bari, Italy.

出版信息

Acta Gastroenterol Belg. 2021 Oct-Dec;84(4):637-656. doi: 10.51821/84.4.015.

DOI:10.51821/84.4.015
PMID:34965046
Abstract

Hepatitis C virus (HCV) is one of the leading causes of chronic liver disease, cirrhosis, and hepatocellular carcinoma, resulting in major global public health concerns. The HCV infection is unevenly distributed worldwide, with variations in prevalence across and within countries. The studies on molecular epidemiology conducted in several countries provide an essential supplement for a comprehensive knowledge of HCV epidemiology, genotypes, and subtypes, along with providing information on the impact of current and earlier migratory flows. HCV is phylogenetically classified into 8 major genotypes and 57 subtypes. HCV genotype and subtype distribution differ according to geographic origin and transmission risk category. Unless people with HCV infection are detected and treated appropriately, the number of deaths due to the disease will continue to increase. In 2015, 1.75 million new viral infections were mostly due to unsafe healthcare procedures and drug use injections. In the same year, access to direct-acting antivirals was challenging and varied in developing and developed countries, affecting HCV cure rates based on their availability. The World Health Assembly, in 2016, approved a global strategy to achieve the elimination of the HCV public health threat by 2030 (by reducing new infections by 90% and deaths by 65%). Globally, countries are implementing policies and measures to eliminate HCV risk based on their distribution of genotypes and prevalence.

摘要

丙型肝炎病毒(HCV)是导致慢性肝病、肝硬化和肝细胞癌的主要原因之一,引起了全球主要的公共卫生关注。HCV 感染在全球分布不均,不同国家和国家内部的流行率存在差异。在几个国家进行的分子流行病学研究为全面了解 HCV 的流行病学、基因型和亚型提供了重要补充,同时还提供了有关当前和早期移民流动影响的信息。HCV 在系统发生上分为 8 个主要基因型和 57 个亚型。HCV 基因型和亚型的分布因地理起源和传播风险类别而异。除非适当发现和治疗 HCV 感染者,否则该疾病的死亡人数将继续增加。2015 年,全球新增 175 万例病毒感染,主要是由于不安全的医疗程序和药物注射。同年,发展中国家和发达国家获得直接作用抗病毒药物的机会有限,影响了根据其供应情况确定的 HCV 治愈率。2016 年,世界卫生大会批准了一项全球战略,到 2030 年消除 HCV 对公共卫生的威胁(将新感染减少 90%,死亡减少 65%)。全球各国正在根据基因型分布和流行率实施消除 HCV 风险的政策和措施。

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