Hussain Md Razeen Ashraf, Hiebert Lindsey, Sugiyama Aya, Ouoba Serge, Bunthen E, Ko Ko, Akita Tomoyuki, Kaneko Shuichi, Kanto Tatsuya, Ward John W, Tanaka Junko
Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi, Japan.
Coalition for Global Hepatitis Elimination, The Task Force for Global Health, Decatur, Georgia, USA.
Hepatol Res. 2022 Nov;52(11):899-907. doi: 10.1111/hepr.13819. Epub 2022 Aug 17.
Achieving hepatitis B virus (HBV) and hepatitis C virus (HCV) elimination requires continuous and sustained high volumes of diagnosis and treatment, which have been affected by the ongoing COVID-19 pandemic. This study assessed the effects of COVID-19 on hepatitis-related services in Japan and compared Japan's situation with a global survey.
We conducted an online cross-sectional questionnaire survey of hepatologists from the Japan Society of Hepatology from August to October 2021 by using the same questionnaire from which a survey was conducted globally to address the effects of COVID-19 on hepatitis-related services. Hepatologists responded based on own impressions of their affiliated institutions.
In total, 196 hepatologists participated from 35 prefectures including 49.5% in managerial positions. Approximately 40% survey participants reported a 1%-25% decline in HBV and HCV screening and confirmatory testing. In addition, 53.6% and 45.4% reported no decline in HBV and HCV treatment initiation, respectively. Comparing any level of decrease with the global survey, there was less of a decline observed in Japan for screening (HBV: 51% vs. 56.3%, HCV: 51% vs. 70.9%) and treatment initiation (HBV: 32.7% vs. 52.4%, HCV: 41.8% vs. 66%). However, patient anxiety/fear (67.4%) and loss of staff due to COVID-19 (49.0%) were reported as challenges for resuming services to pre-COVID-19 levels.
Although in Japan all-inclusive decline in HBV- and HCV-related services were lower than in other countries, a greater decline was observed in HBV and HCV screening and diagnosis than in treatment initiation. Prolonged anxiety/fear among patients, and loss of staff and facilities from the COVID-19 response activities must be addressed to achieve elimination of hepatitis by 2030.
实现消除乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）需要持续且大量的诊断和治疗工作，而这些工作受到了持续的新冠疫情的影响。本研究评估了新冠疫情对日本肝炎相关服务的影响，并将日本的情况与一项全球调查进行了比较。
2021年8月至10月，我们使用与全球调查相同的问卷，对日本肝病学会的肝病专家进行了在线横断面问卷调查，以了解新冠疫情对肝炎相关服务的影响。肝病专家根据他们对所属机构的印象进行了回复。
共有来自35个县的196名肝病专家参与，其中49.5%担任管理职务。约40%的调查参与者报告称，HBV和HCV筛查及确诊检测下降了1%-25%。此外，分别有53.6%和45.4%的参与者报告称HBV和HCV治疗起始量没有下降。将任何程度的下降与全球调查进行比较，日本在筛查（HBV：51%对56.3%，HCV：51%对70.9%）和治疗起始量（HBV：32.7%对52.4%，HCV：41.8%对66%）方面的下降幅度较小。然而，患者焦虑/恐惧（67.4%）和因新冠疫情导致的人员流失（49.0%）被报告为恢复到新冠疫情前服务水平的挑战。
尽管在日本，与HBV和HCV相关服务的全面下降幅度低于其他国家，但HBV和HCV筛查及诊断的下降幅度大于治疗起始量的下降幅度。为了在2030年实现消除肝炎的目标，必须解决患者长期的焦虑/恐惧以及因新冠疫情应对活动导致的人员和设施流失问题。
