2015年日本慢性乙型和丙型肝炎感染负担及未来趋势：一项模拟研究
Burden of chronic hepatitis B and C infections in 2015 and future trends in Japan: A simulation study.
作者信息
Tanaka Junko, Kurisu Akemi, Ohara Masatsugu, Ouoba Serge, Ohisa Masayuki, Sugiyama Aya, Wang Michelle L, Hiebert Lindsey, Kanto Tatsuya, Akita Tomoyuki
机构信息
Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Project Research Center for Epidemiology and Prevention of Viral Hepatitis and Hepatocellular Carcinoma, Hiroshima University, Hiroshima, Japan.
出版信息
Lancet Reg Health West Pac. 2022 Mar 16;22:100428. doi: 10.1016/j.lanwpc.2022.100428. eCollection 2022 May.
BACKGROUND
Determining the number of chronic hepatitis B (HBV) and C virus (HCV) infections is essential to assess the progress towards the World Health Organization 2030 viral hepatitis elimination goals. Using data from the Japanese National Database (NDB), we calculated the number of chronic HBV and HCV infections in 2015 and predicted the trend until 2035.
METHODS
NDB and first-time blood donors data were used to calculate the number of chronic HBV and HCV infections in 2015. A Markov simulation was applied to predict chronic infections until 2035 using transition probabilities calculated from NDB data.
FINDINGS
The total number of chronic HBV and HCV infections in 2015 in Japan was 1,905,187-2,490,873 (HCV:877,841-1,302,179, HBV:1,027,346-1,188,694), of which 923,661-1,509,347 were undiagnosed or diagnosed but not linked to care ("not engaged in care"), and 981,526 were engaged in care. Chronic HBV and HCV infections are expected to be 923,313-1,304,598 in 2030, and 739,118-1,045,884 in 2035. Compared to 2015, by 2035, the number of persons with HCV not engaged in care will decline by 59·8 - 76·1% and 86·5% for patients in care. For HBV, a 47·3 - 49·3% decrease is expected for persons not engaged in care and a decline of 26·0% for patients engaged in care.
INTERPRETATION
Although the burden of HBV and HCV is expected to decrease by 2035, challenges in controlling hepatitis remain. Improved and innovative screening strategies with linkage to care for HCV cases, and a functional cure for HBV are needed.
FUNDING
Japan Ministry of Health, Labour and Welfare.
背景
确定慢性乙型肝炎（HBV）和丙型肝炎病毒（HCV）感染的数量对于评估实现世界卫生组织2030年消除病毒性肝炎目标的进展至关重要。利用日本国家数据库（NDB）的数据，我们计算了2015年慢性HBV和HCV感染的数量，并预测了到2035年的趋势。
方法
使用NDB和首次献血者的数据来计算2015年慢性HBV和HCV感染的数量。应用马尔可夫模拟，利用从NDB数据计算出的转移概率来预测到2035年的慢性感染情况。
研究结果
2015年日本慢性HBV和HCV感染的总数为1,905,187 - 2,490,873例（HCV：877,841 - 1,302,179例，HBV：1,027,346 - 1,188,694例），其中923,661 - 1,509,347例未被诊断或已被诊断但未接受治疗（“未接受治疗”），981,526例接受了治疗。预计到2030年慢性HBV和HCV感染将为923,313 - 1,304,598例，到2035年为739,118 - 1,045,884例。与2015年相比，到2035年，未接受治疗的HCV患者数量将下降59.8 - 76.1%，接受治疗的患者数量将下降86.5%。对于HBV，未接受治疗的患者预计将下降47.3 - 49.3%，接受治疗的患者数量将下降26.0%。
解读
尽管预计到2035年HBV和HCV的负担将有所减轻，但控制肝炎仍面临挑战。需要改进和创新筛查策略，并将HCV病例与治疗联系起来，同时需要对HBV进行功能性治愈。
资金来源
日本厚生劳动省。
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