Venkatesh Rashmi, Huang Andrew S, Gurmessa Kiya, Hsu Edbert B
College of Osteopathic Medicine, William Carey University, Hattiesburg, MS 39401, USA.
Center for Global Emergency Care, Johns Hopkins University, Baltimore, MD 21209, USA.
Healthcare (Basel). 2024 Dec 30;13(1):43. doi: 10.3390/healthcare13010043.
: Direct-acting antiviral agents (DAAs) have significantly reduced Hepatitis C Virus (HCV) transmission and improved health outcomes since their FDA approval in 2011. Despite these advances, over 70 million people remain untreated globally, with a disproportionately high burden in low- and middle-income countries (LMICs). : Through a structured search of open access informational sources and an informal peer-reviewed literature review, HCV treatment barriers were identified, compiled, and analyzed. Current challenges to HCV treatment were organized by themes and summarized as recommendations for LMICs. : Key obstacles to HCV treatment in LMICs are identified, with the underdiagnosis and undertreatment of the disease linked to inadequate funding and healthcare infrastructure for screening and testing, poor awareness among healthcare providers, and the misinformation and stigmatization of HCV disease. : Recommendations for LMICs to attenuate treatment obstacles include distributing educational media, implementing mobile clinics, and fostering international partnerships. The successful implementation of these interventions has been demonstrated in developed countries. : To achieve the WHO's goal of eliminating HCV as a public health threat by 2030, concerted efforts are needed by LMICs to reduce gaps in care and ensure that all patients are afforded access to testing and treatment.
自2011年获得美国食品药品监督管理局（FDA）批准以来，直接抗病毒药物（DAAs）显著降低了丙型肝炎病毒（HCV）的传播，并改善了健康状况。尽管取得了这些进展，但全球仍有超过7000万人未得到治疗，低收入和中等收入国家（LMICs）的负担尤其沉重。通过对开放获取信息源的结构化搜索和非正式的同行评审文献综述，确定、整理并分析了HCV治疗障碍。当前HCV治疗面临的挑战按主题进行了梳理，并总结为针对LMICs的建议。确定了LMICs中HCV治疗的主要障碍，该疾病的诊断不足和治疗不足与筛查和检测的资金及医疗基础设施不足、医疗服务提供者意识淡薄以及HCV疾病的错误信息和污名化有关。针对LMICs减轻治疗障碍的建议包括分发教育媒体、开设流动诊所以及建立国际伙伴关系。这些干预措施的成功实施已在发达国家得到证明。为实现世界卫生组织到2030年消除HCV作为公共卫生威胁的目标，LMICs需要共同努力，缩小护理差距，确保所有患者都能获得检测和治疗。
