Tsai Wei-Chu, Chiang Hseuh-Chien, Chiu Yen-Cheng, Chien Shih-Chieh, Cheng Pin-Nan, Chiu Hung-Chih
Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan.
Life (Basel). 2023 Sep 26;13(10):1964. doi: 10.3390/life13101964.
With the advent of direct-acting antiviral agents (DAA) in the recent few years, hepatitis C virus (HCV) infection has become a curable infectious disease. Successful clearance of HCV could lead to improvement of both hepatic and extrahepatic outcomes, such as complications of cirrhosis, hepatocellular carcinoma, cardiovascular diseases, and incident diabetes. However, challenges persist in reaching the HCV elimination goals of the World Health Organization by 2030. Among these challenges are identifying those already infected or undiagnosed subjects, re-linking to the care of known but untreated HCV-infected subjects, and developing strategies to enhance treatment rates and compliance in specific or high-risk populations. In addition, issues of post-DAA viral clearance, including avoiding or preventing reinfection in high-risk populations and surveillance of hepatocellular carcinoma, are important to consolidate the treatment's short- and long-term efficacies. In the current DAA era, treatment is the most effective prevention strategy not only in its excellent efficacy and safety but also in preventing HCV spread. All of the surveillance or measures should center on DAA treatment in clinical practice.
近年来，随着直接作用抗病毒药物（DAA）的出现，丙型肝炎病毒（HCV）感染已成为一种可治愈的传染病。成功清除HCV可改善肝脏和肝外疾病的预后，如肝硬化并发症、肝细胞癌、心血管疾病和新发糖尿病。然而，在实现世界卫生组织到2030年消除HCV的目标方面，挑战依然存在。这些挑战包括识别那些已经感染或未被诊断的受试者，重新将已知但未接受治疗的HCV感染受试者与治疗联系起来，以及制定策略以提高特定或高危人群的治疗率和依从性。此外，DAA治疗后病毒清除的问题，包括在高危人群中避免或预防再感染以及肝细胞癌的监测，对于巩固治疗的短期和长期疗效很重要。在当前的DAA时代，治疗不仅因其卓越的疗效和安全性，而且在预防HCV传播方面，是最有效的预防策略。在临床实践中，所有的监测或措施都应以DAA治疗为中心。
