Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA.
J Infect Dis. 2024 May 8;229(Supplement_3):S362-S369. doi: 10.1093/infdis/jiad177.
The current multiday diagnosis and treatment paradigm for hepatitis C virus (HCV) infection results in far fewer patients receiving treatment with direct-acting antiviral agents than those with diagnosed HCV infection. To achieve HCV elimination, a paradigm shift in access to HCV treatment is needed from multiday testing and treatment algorithms to same-day diagnosis and treatment. This shift will require new tools, such as point-of-care (POC) antigen tests or nucleic acid tests for HCV and hepatitis B virus (HBV) and nucleic acid tests for human immunodeficiency virus (HIV) that do not require venous blood. This shift will also require better use of existing resources, including expanded access to HCV treatment and available POC tests, novel monitoring approaches, and removal of barriers to approval. A same-day diagnosis and treatment paradigm will substantially contribute to HCV elimination by improving HCV treatment rates and expanding access to treatment in settings where patients have brief encounters with healthcare.
目前,丙型肝炎病毒 (HCV) 感染的多日诊断和治疗模式导致接受直接作用抗病毒药物治疗的患者远远少于已诊断 HCV 感染的患者。为了实现 HCV 的消除,需要从多日检测和治疗算法向当日诊断和治疗转变,以获得 HCV 治疗的途径。这种转变将需要新的工具,例如用于 HCV 和乙型肝炎病毒 (HBV) 的即时检测抗原测试或核酸测试,以及用于 HIV 的核酸测试,这些测试无需静脉采血。这种转变还将需要更好地利用现有资源,包括扩大 HCV 治疗的可及性和现有的即时检测测试、新型监测方法以及消除批准的障碍。当日诊断和治疗模式将通过提高 HCV 治疗率并扩大在患者与医疗保健机构短暂接触的环境中获得治疗的机会,为 HCV 的消除做出重大贡献。