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美国慢性乙型肝炎感染治疗中的差距与差异。

Gaps and disparities in the treatment of chronic hepatitis B infection in the USA.

作者信息

Wong Robert J

机构信息

Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, CA, USA.

Gastroenterology Section, Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA, USA.

出版信息

Gastroenterol Rep (Oxf). 2025 Feb 6;13:goaf016. doi: 10.1093/gastro/goaf016. eCollection 2025.

Abstract

Chronic hepatitis B (CHB) infection affects nearly 300 million individuals worldwide and is a leading cause of hepatocellular carcinoma and liver-related mortality. However, major gaps in the CHB cascade of care persist, with the majority of individuals with CHB not diagnosed and not linked to care and treatment. Even among individuals with known CHB, existing studies report on major gaps and disparities in timely linkage to care and timely access to CHB therapies. While the momentum to expand and simplify CHB treatment guidelines is promising, access to treatment still relies on individuals being effectively engaged in clinical care and liver disease monitoring. The contributing factors to the observed gaps and disparities in the CHB cascade of care are complex and multifactorial, and there is no one-size-fits-all solution than can be easily applied across all global regions. However, any serious approach towards addressing the existing gaps in the CHB cascade of care to improve patient outcomes requires a concerted investment from healthcare institutions, governments, policymakers, and industry partners to provide the necessary resources to be able to achieve this goal. Anything less than a comprehensive and collaborative approach that engages all stakeholders to invest effort and resources into tackling the global epidemic of CHB will continue to fall short in making progress towards global viral hepatitis elimination goals.

摘要

慢性乙型肝炎(CHB)感染影响着全球近3亿人,是肝细胞癌和肝脏相关死亡的主要原因。然而,CHB治疗流程中仍存在重大差距,大多数CHB患者未被诊断,也未与治疗和护理建立联系。即使在已知患有CHB的个体中,现有研究也报告了在及时获得护理和及时获得CHB治疗方面存在的重大差距和差异。虽然扩大和简化CHB治疗指南的势头很有前景,但获得治疗仍然依赖于个体有效地参与临床护理和肝病监测。CHB治疗流程中观察到的差距和差异的促成因素复杂且多方面,没有一种万能的解决方案可以轻松应用于所有全球区域。然而,任何认真解决CHB治疗流程中现有差距以改善患者预后的方法都需要医疗机构、政府、政策制定者和行业合作伙伴的共同投资,以提供实现这一目标所需的资源。任何低于全面协作方法的做法,即让所有利益相关者投入精力和资源来应对全球CHB流行,在朝着全球消除病毒性肝炎目标取得进展方面仍将继续不足。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdd0/11802464/aafa496360f1/goaf016f1.jpg

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