Gastroenterology and Hepatology Department, Centro Hospitalar Universitário de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
World Gastroenterology Organization (WGO) Porto Training Center, Porto, Portugal.
Eur J Clin Microbiol Infect Dis. 2022 Mar;41(3):341-347. doi: 10.1007/s10096-021-04395-z. Epub 2022 Jan 13.
Infection with hepatitis C virus (HCV) is a major public health problem. In fact, chronic HCV is a leading cause of cirrhosis, hepatocellular carcinoma, and death from liver disease in most countries. The advent of highly effective oral direct-acting antiviral therapy is the most significant advance in the treatment of HCV in decades and now allows us to cure chronic HCV. However, a large number of infected patients have not been diagnosed since hepatitis C is a largely asymptomatic disease. Thus, it is fundamental to improve the screening system in order to identify individuals who are currently infected and to treat them. Risk-based hepatitis C testing and birth cohort screening have had limited success and many patients living with the infection are not aware of their status. Universal screening for HCV is a tremendous improvement compared with the previous strategies. Indeed, global screening leads to the appropriate identification and treatment of all individuals chronically infected with HCV and prevents the progression of liver disease and the associated morbidity and mortality. In addition, universal HCV testing appears to be cost-effective. In this article, we review the current barriers to HCV eradication and the different strategies for HCV infection screening.
丙型肝炎病毒 (HCV) 感染是一个重大的公共卫生问题。事实上，在大多数国家，慢性 HCV 是导致肝硬化、肝细胞癌和肝病死亡的主要原因。高效口服直接作用抗病毒治疗的出现是 HCV 治疗几十年来最重大的进展，现在使我们能够治愈慢性 HCV。然而，由于 HCV 是一种基本无症状的疾病，大量受感染的患者尚未被诊断出来。因此，改进筛查系统以确定目前感染的个体并对其进行治疗至关重要。基于风险的 HCV 检测和出生队列筛查的效果有限，许多携带感染的患者并不知道自己的状况。与之前的策略相比，普遍筛查 HCV 是一个巨大的进步。事实上，全球筛查可适当识别和治疗所有慢性 HCV 感染者，并防止肝病进展以及相关发病率和死亡率。此外，普遍 HCV 检测似乎具有成本效益。本文综述了 HCV 消除的当前障碍以及 HCV 感染筛查的不同策略。
