Marrapu Sudheer, Kumar Ramesh
Department of Gastroenterology, All India Institute of Medical Sciences, Patna 801507, India.
World J Hepatol. 2024 Oct 27;16(10):1151-1157. doi: 10.4254/wjh.v16.i10.1151.
Hepatitis B remains a significant global health challenge, contributing to substantial morbidity and mortality. Approximately 254 million people worldwide live with Chronic hepatitis B (CHB), with the majority of cases occurring in sub-Saharan Africa and the Western Pacific regions. Alarmingly, only about 13.4% of the individuals infected with this disease have been diagnosed, and awareness of hepatitis B virus (HBV) infection status is as low as 1% in sub-Saharan Africa. In 2022, CHB led to 1.1 million deaths globally. The World Health Organization (WHO) has set a target of eliminating hepatitis B as a public health concern by 2030; however, this goal appears increasingly unattainable due to multiple challenges. These challenges include low vaccination coverage; a large number of undiagnosed cases; a low proportion of patients eligible for treatment under current guidelines; limited access to healthcare; and the costs associated with lifelong treatment. Treatment of HBV can yield significant clinical benefits within a long window of opportunity. However, the benefits of therapy are markedly diminished when the disease is detected at the advanced cirrhosis stage. This editorial aim to highlight the current challenges in hepatitis care and the necessary steps to achieve the WHO's hepatitis elimination goals for 2030.
乙型肝炎仍然是一项重大的全球卫生挑战，导致大量发病和死亡。全球约有2.54亿人患有慢性乙型肝炎（CHB），大多数病例发生在撒哈拉以南非洲和西太平洋地区。令人担忧的是，感染这种疾病的人中只有约13.4%得到了诊断，在撒哈拉以南非洲，对乙型肝炎病毒（HBV）感染状况的知晓率低至1%。2022年，慢性乙型肝炎在全球导致110万人死亡。世界卫生组织（WHO）设定了到2030年消除乙型肝炎这一公共卫生问题的目标；然而，由于多重挑战，这一目标似乎越来越难以实现。这些挑战包括疫苗接种覆盖率低；大量未诊断病例；符合现行指南治疗条件的患者比例低；获得医疗保健的机会有限；以及与终身治疗相关的费用。治疗HBV在较长的机会窗口期内可产生显著的临床益处。然而，当疾病在晚期肝硬化阶段被检测到时，治疗的益处会明显减少。这篇社论旨在强调当前肝炎护理方面的挑战以及实现世卫组织2030年肝炎消除目标所需采取的步骤。
