Crespo Javier, Cabezas Joaquín, Castro-Narro Graciela, Cheinquer Hugo, Contreras Fernando, Hernandez Nelia, Perelló Christie, Ridruejo Ezequiel, Calleja José Luís
Gastroenterology and Hepatology Department, University Hospital Marqués de Valdecilla, Santander, Spain.
Research Institute Valdecilla (IDIVAL in Spanish), Santander, Spain.
Front Public Health. 2025 May 16;13:1527704. doi: 10.3389/fpubh.2025.1527704. eCollection 2025.
The REVIRAL project proposes a comprehensive and tailored strategy for the elimination of viral hepatitis in Latin America, drawing inspiration from successful models in other countries. Despite global advances, the region faces specific barriers, including the lack of universal screening programs, disparities in access to direct-acting antiviral treatments, the presence of fragmented health systems, and the social stigma associated with these infections. These factors hinder progress towards elimination, necessitating collaborative responses tailored to the epidemiological and socioeconomic realities of each country. The project's structure is organized into three fundamental phases: The first phase involves an initial assessment, where the epidemiological situation of each country will be analyzed, specifically the prevalence and incidence data of viral hepatitis and the response capacity of each country's health systems. This phase will also identify specific barriers, allowing interventions to be adjusted to local needs. The second phase will focus on the implementation of intervention programs, promoting universal screening, strengthening healthcare personnel training, and implementing health models that enhance linkage-to-care. The third phase will concentrate on monitoring and evaluating results through a global elimination marker, designed to measure and compare progress across countries. The success of REVIRAL will largely depend on the commitment of local governments and international cooperation. If implemented correctly, the project could transform the public health response to viral hepatitis in Latin America and serve as a replicable model for other regions with similar challenges advancing toward the WHO's global elimination goals set for 2030.
“REVIRAL项目”提出了一项全面且量身定制的战略,旨在消除拉丁美洲的病毒性肝炎,其灵感源自其他国家的成功模式。尽管全球在这方面取得了进展,但该地区面临着一些特殊障碍,包括缺乏全民筛查计划、在获得直接抗病毒治疗方面存在差异、卫生系统碎片化,以及与这些感染相关的社会耻辱感。这些因素阻碍了消除工作的进展,因此需要针对每个国家的流行病学和社会经济现实采取协同应对措施。该项目的架构分为三个基本阶段:第一阶段是初步评估,将分析每个国家的流行病学情况,特别是病毒性肝炎的患病率和发病率数据以及每个国家卫生系统的应对能力。这一阶段还将确定具体障碍,以便根据当地需求调整干预措施。第二阶段将专注于实施干预计划,推动全民筛查,加强医护人员培训,并实施能够加强就医衔接的健康模式。第三阶段将通过一个全球消除指标集中监测和评估结果,该指标旨在衡量和比较各国的进展情况。“REVIRAL项目”的成功很大程度上取决于地方政府的承诺和国际合作。如果实施得当,该项目可以改变拉丁美洲对病毒性肝炎的公共卫生应对方式,并成为其他面临类似挑战、朝着世界卫生组织设定的2030年全球消除目标迈进的地区可复制的模式。