PDF下载 ( 689 KB)
中国丙型肝炎病毒感染的现状及清除进程
DOI: 10.12449/JCH240401
利益冲突声明：本文不存在任何利益冲突。
作者贡献声明：陈红松、饶慧瑛负责构思，拟定写作思路；张海莹负责查阅和分析资料，撰写论文；陈红松、饶慧瑛负责指导撰写文章并最后定稿。
Current status of hepatitis C virus infection and progress in its elimination in China
-
摘要: 丙型肝炎可发展为肝硬化或者肝细胞癌，给患者家庭和社会造成沉重的疾病负担。丙型肝炎是人类面临的重大公共威胁之一，消除丙型肝炎是人类共同的目标。直接抗病毒药物（DAA）治疗是目前较为安全可达到较高的治愈率的丙型肝炎治疗方案，可以靶向不同HCV基因型，使得HCV感染消除成为可能。我国积极推广DAA临床应用，加快药物审批，提高DAA可及性，加强人群干预。国家医疗保障局逐步将DAA纳入国家医保目录，为消除HCV感染提供了有力保障。为响应世界卫生组织提出的2030年消除病毒性肝炎作为公共卫生危害的目标，近年来我国相继发布国家策略规划及行动计划，在HCV感染消除工作中取得了较大的成就，形成全社会多部门联合防治，积极迈向消除HCV感染的目标。本文着眼于国内HCV感染的现状和防治工作进展突出的防治消除策略，分析总结HCV感染防治微消除的实践进程，为我国开展HCV感染消除工作提供政策参考，助力实现全面消除HCV感染的目标。Abstract: Hepatitis C virus （HCV） can develop into liver cirrhosis or hepatocellular carcinoma， imposing a heavy burden on the patient’s family and the society. Hepatitis C is one of the major public threats for humans， and eliminating hepatitis C is a common goal of all humans. Direct-acting antiviral agents （DAAs） are currently a relatively safe treatment regimen for hepatitis C that can reach a relatively high cure rate and can target different HCV genotypes， making it possible to eliminate HCV infection. China actively promotes the clinical application of DAAs， accelerates drug approval， improves the accessibility of DAAs， and strengthens population intervention. National Medical Insurance Administration has gradually included DAAs in the national medical insurance directory， providing strong support for eliminating HCV infection. In response to the WHO’s goal of eliminating viral hepatitis as a public health hazard by 2030， China has successively released national strategic plans and action plans in recent years， making significant achievements in HCV infection elimination， forming a joint prevention and control system across multiple sectors of the society， and ultimately achieving the goal of eliminating HCV infection. With a focus on the current status of HCV infection in China and prominent prevention and control strategies， this article analyzes and summarizes the practical process of the prevention， control， and micro-elimination of HCV infection， in order to provide a policy reference for carrying out HCV elimination in China and help to achieve the goal of comprehensive elimination of HCV infection.
-
Key words:
- Hepatitis C /
- Infections /
- Disease Eradication
-
[1] CUI FQ, BLACH S, MANZENGO MINGIEDI C, et al. Global reporting of progress towards elimination of hepatitis B and hepatitis C[J]. Lancet Gastroenterol Hepatol, 2023, 8( 4): 332- 342. DOI: 10.1016/S2468-1253(22)00386-7. [2] World Health Organization. Global Health Sector Strategy on Viral Hepatitis 2016- 2021. Towards Ending Viral Hepatitis,2016[M/OL].( 2016-05-17). https://www.who.int/publications/i/item/WHO-HIV-2016.06. https://www.who.int/publications/i/item/WHO-HIV-2016.06 [3] World Health Organization. Combating Hepatitis B and C to Reach Elimination by 2030[M/OL].( 2016-05-27). https://www.who.int/publications/i/item/combating-hepatitis-b-and-c-to-reach-elimination-by-2030. https://www.who.int/publications/i/item/combating-hepatitis-b-and-c-to-reach-elimination-by-2030 [4] LE LV, BLACH S, REWARI B, et al. Progress towards achieving viral hepatitis B and C elimination in the Asia and Pacific region: Results from modelling and global reporting[J]. Liver Int, 2022, 42( 9): 1930- 1934. DOI: 10.1111/liv.15131. [5] MARTINELLO M, SOLOMON SS, TERRAULT NA, et al. Hepatitis C[J]. Lancet, 2023, 402( 10407): 1085- 1096. DOI: 10.1016/s0140-6736(23)01320-x. [6] SCHINAZI RF, ASSELAH T. From HCV to HBV cure[J]. Liver Int, 2017, 37( Suppl 1): 73- 80. DOI: 10.1111/liv.13324. [7] BUTI M, LURIE Y, ZAKHAROVA NG, et al. Randomized trial of peginterferon alfa-2b and ribavirin for 48 or 72 weeks in patients with hepatitis C virus genotype 1 and slow virologic response[J]. Hepatology, 2010, 52( 4): 1201- 1207. DOI: 10.1002/hep.23816. [8] COLLABORATORS POH. Global change in hepatitis C virus prevalence and cascade of care between 2015 and 2020: A modelling study[J]. Lancet Gastroenterol Hepatol, 2022, 7( 5): 396- 415. DOI: 10.1016/S2468-1253(21)00472-6. [9] RAO HY, WEI L, LOPEZ-TALAVERA JC, et al. Distribution and clinical correlates of viral and host genotypes in Chinese patients with chronic hepatitis C virus infection[J]. J Gastroenterol Hepatol, 2014, 29( 3): 545- 553. DOI: 10.1111/jgh.12398. [10] GOWER E, ESTES C, BLACH S, et al. Global epidemiology and genotype distribution of the hepatitis C virus infection[J]. J Hepatol, 2014, 61( 1 Suppl): S45- S57. DOI: 10.1016/j.jhep.2014.07.027. [11] WANG H, QIU Q, YUAN QL, et al. Epidemiological characteristics of incident cases and risk factors of hepatitis C infection in Beijing City from 2004 to 2021[J]. Chin J Prev Med, 2023, 57( 9): 1391- 1395. DOI: 10.3760/cma.j.cn112150-20221024-01026.王怀, 邱倩, 袁千里, 等. 2004—2021年北京市丙型肝炎流行特征及感染相关因素分析[J]. 中华预防医学杂志, 2023, 57( 9): 1391- 1395. DOI: 10.3760/cma.j.cn112150-20221024-01026. [12] DING X, REN DF, GAO QR, et al. Epidemiological characteristics of hepatitis C in Tongren from 2006 to 2020[J]. Mod Prev Med, 2022, 49( 6): 1003- 1005, 1015.丁旭, 任达飞, 高前荣, 等. 2006—2020年贵州省铜仁市丙型病毒性肝炎流行特征分析[J]. 现代预防医学, 2022, 49( 6): 1003- 1005, 1015. [13] LI N, FAN JX, QIU BH, et al. Epidemiological characteristics of hepatitis C in Jilin Province, 2012-2021[J]. Pract Prev Med, 2023, 30( 4): 474- 476. DOI: 10.3969/j.issn.1006-3110.2023.04.020.李娜, 范吉祥, 邱柏红, 等. 2012—2021年吉林省丙型肝炎流行病学特征分析[J]. 实用预防医学, 2023, 30( 4): 474- 476. DOI: 10.3969/j.issn.1006-3110.2023.04.020. [14] QIN LJ, LIU Y, GUO SM, et al. Prevalence characteristics and trend forecast of hepatitis C in Erqi district of Zhengzhou from 2013 to 2022[J]. J Henan Med Coll, 2023, 35( 5): 534- 538. DOI: 10.3969/j.issn.1008-9276.2023.05.015.秦利娟, 刘玉, 郭素梅, 等. 2013—2022年郑州市二七区丙型肝炎流行特征及趋势预测[J]. 河南医学高等专科学校学报, 2023, 35( 5): 534- 538. DOI: 10.3969/j.issn.1008-9276.2023.05.015. [15] XIAO L, TANG Y, WANG FS, et al. Epidemic status of viral hepatitis C in a district of Beijing, 2010—2022[J]. Cap J Public Health, 2023, 17( 5): 312- 315. DOI: 10.16760/j.cnki.sdggws.2023.05.008.肖雷, 唐莹, 王凤双, 等. 2010—2022年北京市某区丙型病毒性肝炎流行现状分析[J]. 首都公共卫生, 2023, 17( 5): 312- 315. DOI: 10.16760/j.cnki.sdggws.2023.05.008. [16] LIN CN, FENG Y, FENG XW. Current status of hepatitis C treatment and analysis of medical insurance compensation mechanism[J]. China Health Ind, 2022, 19( 5): 163- 167. DOI: 10.16659/j.cnki.1672-5654.2022.05.163.蔺朝妮, 冯玉, 冯晓伟. 丙型肝炎治疗现状与医保补偿机制分析[J]. 中国卫生产业, 2022, 19( 5): 163- 167. DOI: 10.16659/j.cnki.1672-5654.2022.05.163. [17] DU GP, LI XS, MUSA TH, et al. The nationwide distribution and trends of hepatitis C virus genotypes in Mainland China[J]. J Med Virol, 2019, 91( 3): 401- 410. DOI: 10.1002/jmv.25311. [18] YANG J, LIU HX, SU YY, et al. Distribution and changes in hepatitis C virus genotype in China from 2010 to 2020[J]. World J Clin Cases, 2022, 10( 14): 4480- 4493. DOI: 10.12998/wjcc.v10.i14.4480. [19] FENG XF, DING GW, YU HL, et al. Current status of hepatitis C diagnosis and treatment in Chinese medical institutions[J]. Chin J AIDS STD, 2020, 26( 3): 247- 249. DOI: 10.13419/j.cnki.aids.2020.03.06.冯小飞, 丁国伟, 俞海亮, 等. 医疗机构丙型肝炎诊断治疗现况研究[J]. 中国艾滋病性病, 2020, 26( 3): 247- 249. DOI: 10.13419/j.cnki.aids.2020.03.06. [20] LIU LL, XU HQ, HU Y, et al. Hepatitis C screening in hospitals: Find the missing patients[J]. Virol J, 2019, 16( 1): 47. DOI: 10.1186/s12985-019-1157-1. [21] HE N, HAO S, FENG G, et al. Analysis of the factors influencing the elimination strategies with the current status of diagnosis and treatment of hepatitis C in hospital[J]. Chin J Hepatol, 2021, 29( 11): 1053- 1058. DOI: 10.3760/cma.j.cn501113-20210119-00034.贺娜, 郝帅, 冯巩, 等. 医院内丙型肝炎诊治现状对院内消除策略的影响因素分析[J]. 中华肝脏病杂志, 2021, 29( 11): 1053- 1058. DOI: 10.3760/cma.j.cn501113-20210119-00034. [22] National Health Commission of the People’s Republic of China. Action Plan for Eliminating Public Health Hazards of Hepatitis C( 2021-2030)[EB/OL]. http://www.nhc.gov.cn/cms-search/xxgk/getManuscriptXxgk.htm?id=c462ec94e6d14d8291c5309406603153. http://www.nhc.gov.cn/cms-search/xxgk/getManuscriptXxgk.htm?id=c462ec94e6d14d8291c5309406603153中华人民共和国国家卫生健康委员会. 消除丙型肝炎公共卫生危害行动工作方案( 2021- 2030 年)[EB/OL]. http://www.nhc.gov.cn/cms-search/xxgk/getManuscriptXxgk.htm?id=c462ec94e6d14d8291c5309406603153. http://www.nhc.gov.cn/cms-search/xxgk/getManuscriptXxgk.htm?id=c462ec94e6d14d8291c5309406603153 [23] China Liver Health; Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Laboratory Medicine, Chinese Medical Association; Hospital Infection Management Committee of Chinese Hospital Association. In-hospital process for viral hepatitis C screening and management in China(Draft)[J]. J Clin Hepatol, 2021, 37( 7): 1534- 1539. DOI: 10.3969/j.issn.1001-5256.2021.07.011.中联肝健康促进中心, 中华医学会肝病学分会, 中华医学会检验医学分会, 等. 中国丙型病毒性肝炎院内筛查管理流程(试行)[J]. 临床肝胆病杂志, 2021, 37( 7): 1534- 1539. DOI: 10.3969/j.issn.1001-5256.2021.07.011. [24] Chinese Society of Health Management, Chinese Society of Hepatology, Chinese Society of Laboratory Medicine. Expert consensus on viral hepatitis health management(2021)[J]. Chin J Health Manag, 2021, 15( 4): 323- 331. DOI: 10.3760/cma.j.cn115624-20210531-00305.中华医学会健康管理学分会, 中华医学会肝病学分会, 中华医学会检验医学分会. 病毒性肝炎健康管理专家共识(2021年)[J]. 中华健康管理学杂志, 2021, 15( 4): 323- 331. DOI: 10.3760/cma.j.cn115624-20210531-00305. [25] Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association. Guideline for the prevention and treatment of hepatitis C(2022 version)[J]. Chin J Hepatol, 2022, 30( 12): 1332- 1348. DOI: 10.3760/cma.j.cn501113-20221220-00605.中华医学会肝病学分会, 中华医学会感染病学分会. 丙型肝炎防治指南(2022年版)[J]. 中华肝脏病杂志, 2022, 30( 12): 1332- 1348. DOI: 10.3760/cma.j.cn501113-20221220-00605. [26] WU T, LIN F, WANG J, et al. Hepatitis C elimination among drug users in China:challenges,strategies and experiences[J]. Chin J Hepatol, 2022, 30( 9): 1002- 1006. DOI: 10.3760/cma.j.cn501113-20210311-00116.吴涛, 林锋, 王姣, 等. 中国吸毒人群中的丙型肝炎消除: 挑战、策略和经验[J]. 中华肝脏病杂志, 2022, 30( 9): 1002- 1006. DOI: 10.3760/cma.j.cn501113-20210311-00116. [27] CHENG HH, CAI DC. Enlightenment of practical experience of eliminating hepatitis C at home and abroad to update the prevention and treatment strategy of hepatitis C in China[J]. Chin J Infect Dis, 2023, 41( 3): 230- 233. DOI: 10.3760/cma.j.cn311365-20220428-00152.程欢欢, 蔡大川. 国内外消除丙型肝炎的实践经验对更新我国丙型肝炎防治策略的启发[J]. 中华传染病杂志, 2023, 41( 3): 230- 233. DOI: 10.3760/cma.j.cn311365-20220428-00152. [28] LUO XH, LIANG YD, PENG H, et al. Exploring the health education model for chronic hepatitis C micro-elimination in Guizhou Province from a global perspectives[J]. Chin J Hepatol, 2020, 28( 10): 816- 819. DOI: 10.3760/cma.j.cn501113-20200831-00484.罗新华, 梁跃东, 彭虹, 等. 从全球丙型肝炎微消除模式到贵州省慢性丙型肝炎健康教育模式的探索[J]. 中华肝脏病杂志, 2020, 28( 10): 816- 819. DOI: 10.3760/cma.j.cn501113-20200831-00484. [29] RAO HY, LI MY, WEI L. Elimination of hepatitis C,ourprogress,challenges and hopes[J]. Chin J Hepatol, 2020, 28( 10): 809- 811. DOI: 10.3760/cma.j.cn501113-20200929-00538.饶慧瑛, 李明阳, 魏来. 消除丙型肝炎, 我们的进展、挑战和希望[J]. 中华肝脏病杂志, 2020, 28( 10): 809- 811. DOI: 10.3760/cma.j.cn501113-20200929-00538. [30] YIM HJ. Elimination of hepatitis C: What would be the practical approach?[J]. Clin Mol Hepatol, 2021, 27( 1): 97- 99. DOI: 10.3350/cmh.2020.0304. [31] BAO YP, LARNEY S, PEACOCK A, et al. Prevalence of HIV, HCV and HBV infection and sociodemographic characteristics of people who inject drugs in China: A systematic review and meta-analysis[J]. Int J Drug Policy, 2019, 70: 87- 93. DOI: 10.1016/j.drugpo.2019.05.005. [32] LI J, PANG L, LI DM, et al. Hepatitis C case report and sentinel surveillance in China from 2015 to 2021[J]. Chin J AIDS STD, 2023, 29( 6): 634- 638. DOI: 10.13419/j.cnki.aids.2023.06.04.李健, 庞琳, 李东民, 等. 2015—2021年我国丙型肝炎病例报告与哨点监测分析[J]. 中国艾滋病性病, 2023, 29( 6): 634- 638. DOI: 10.13419/j.cnki.aids.2023.06.04. -
本文二维码
计量
- 文章访问数: 602
- HTML全文浏览量: 234
- PDF下载量: 242
- 被引次数: 0
下载:
