消除病毒性肝炎公共卫生威胁，机遇与挑战并存

杨仕贵

doi:10.16462/j.cnki.zhjbkz.2021.07.002

消除病毒性肝炎公共卫生威胁，机遇与挑战并存

doi: 10.16462/j.cnki.zhjbkz.2021.07.002

杨仕贵^,

310003 杭州，浙江大学医学院附属第一医院，浙江大学传染病诊治国家重点实验室，感染性疾病诊治协同创新中心，浙江大学国家感染性疾病临床医学研究中心

基金项目:

国家自然科学基金 U1611264

国家自然科学基金 81672005

国家科技重大专项 2018ZX10715-014-002

国家科技重大专项 2014ZX10004008

科技部中青年科技创新领军人才 2017RA2120

详细信息

通讯作者:
杨仕贵，E-mail: yangshigui@zju.edu.cn

中图分类号: R512.6
计量
- 文章访问数: 450
- HTML全文浏览量: 270
- PDF下载量: 162
- 被引次数: 0
出版历程
- 收稿日期: 2021-05-23
- 修回日期: 2021-06-23
- 网络出版日期: 2021-08-13
- 刊出日期: 2021-07-10

Eliminating the public health threat of viral hepatitis in situation with both opportunities and challenges

YANG Shi-gui^,

The First Affiliated Hospital, College of Medicine, Zhejiang University, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases Zhejiang University, National Clinical Research Center for Infectious Diseases Zhejiang University, Hangzhou 310003, China

Funds:

National Natural Science Foundation of China U1611264

National Natural Science Foundation of China 81672005

National Science and Technology Major Project 2018ZX10715-014-002

National Science and Technology Major Project 2014ZX10004008

Fund of Young and middle-aged scientific and technological innovation leaders of the Ministry of Science and Technology 2017RA2120

More Information

Corresponding author: YANG Shi-gui, E-mail: yangshigui@zju.edu.cn

摘要

摘要: 在过去的30年中，随着甲型肝炎、乙型肝炎和戊型肝炎的疫苗普及，全球在控制病毒性肝炎的新发感染率和发病率上取得了巨大效果。与此同时，随着针对丙型肝炎的新型抗病毒药物的成功研发，也为消除丙型肝炎的公共卫生威胁带来希望。然而，由于病毒性肝炎的早期诊断率不高、疫苗和抗病毒药物的获得性在国家或地区间不均衡以及对病毒性肝炎危害性的认识不足等原因，病毒性肝炎的疾病负担依然较重，仍是一项全球性的公共卫生问题。因此，消除病毒性肝炎的公共卫生危害需要完善现有的应对策略，强化疫苗免疫、扩大筛查力度、普及抗病毒治疗等综合性措施。本文就全球及中国病毒性肝炎的流行概况、防治现状、WHO消除病毒性肝炎公共卫生危害的目标及所采取的行动计划作一探讨。
- 病毒性肝炎 /
- 疾病负担 /
- 预防控制
Abstract: In the past three decades, with the implementation of vaccinating against hepatitis A, hepatitis B and hepatitis E, it has achieved remarkable achievements in controlling incidence and prevalence of viral hepatitis. At the same time, the successful development of direct-acting antiviral agents (DAA) for hepatitis C also brings hope for eliminating the public health threat of hepatitis C. However, due to the low rate of early diagnosis of viral hepatitis, the uneven availability of vaccines and antiviral drugs among countries or regions, and the lack of awareness of the harmfulness of viral hepatitis, the disease burden of viral hepatitis is still heavy. It remains a severe public health problem in global. Therefore, to eliminate the public health threat of viral hepatitis, it is necessary to improve the existing coping strategies, strengthen vaccine immunization, expand screening, and popularize antiviral treatment and other comprehensive measures. This article discusses the epidemic situation of viral hepatitis in China and the world, the current situation of prevention and treatment, the goal of WHO to eliminate the public health threat of viral hepatitis, and the action plan adopted.
- Viral hepatitis /
- Disease burden /
- Prevention and control

HTML全文

参考文献(23)

[1]	Asrani SK, Devarbhavi H, Eaton J, et al. Burden of liver diseases in the world[J]. J Hepatol, 2019, 70(1): 151-171. DOI: 10.1016/j.jhep.2018.09.014.
[2]	Stanaway JD, Flaxman AD, Naghavi M, et al. The global burden of viral hepatitis from 1990 to 2013: findings from the Global Burden of Disease Study 2013[J]. Lancet, 2016, 388(10049): 1081-1088. DOI: 10.1016/S0140-6736(16)30579-7.
[3]	World Health Organization. Draft global health sector strategy on viral hepatitis, 2016-2021. [EB/OL]. (2016-06-01)[2021-05-01]. https://www.emcdda.europa.eu/system/files/attachments/9478/WHO-HIV-2016.06-eng.pdf.
[4]	GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016[J]. Lancet, 2017, 390(10100): 1151-1210. DOI: 10.1016/S0140-6736(17)32152-9.
[5]	World Health Organization. WHO position paper on hepatitis A vaccines - June 2012[J]. Wkly Epidemiol Rec, 2012, 87(28/29): 261-276.
[6]	Alventosa MC, Urquijo PJ, Diago MM. An outbreak of acute hepatitis due to the hepatitis A virus in 2017: are we witnessing a change in contagion risk factors?[J]. Rev Esp Enferm Dig, 2018, 110(10): 675-676. DOI: 10.17235/reed.2018.5633/2018.
[7]	Wang H, Gao P, Chen WX, et al. Changing epidemiological characteristics of Hepatitis A and warning of Anti-HAV immunity in Beijing, China: a comparison of prevalence from 1990 to 2017[J]. Hum Vaccin Immunother, 2019, 15(2): 420-425. DOI: 10.1080/21645515.2018.1529128.
[8]	Croker C, Hathaway S, Marutani A, et al. Outbreak of hepatitis A virus infection among adult patients of a mental hospital - Los Angeles County, 2017[J]. Infect Control Hosp Epidemiol, 2018, 39(7): 881. DOI: 10.1017/ice.2018.77.
[9]	Souto FJD, de Brito WI, Fontes CJF. Impact of the single-dose universal mass vaccination strategy against hepatitis A in Brazil[J]. Vaccine, 2019, 37(6): 771-775. DOI: 10.1016/j.vaccine.2018.12.054.
[10]	Örmeci N, Malhan S, Balik I, et al. Scenarios to manage the hepatitis C disease burden and associated economic impact of treatment in Turkey[J]. Hepatol Int, 2017, 11(6): 509-516. DOI: 10.1007/s12072-017-9820-3.
[11]	陈园生, 王旭霞, 尚鹏辉, 等. 中国人群乙型肝炎病毒表面抗原流行规律变迁的初步研究[J]. 中华实验和临床感染病杂志(电子版), 2007, 1(1): 20-21. DOI: 10.3969/j.issn.1674-1358.2007.01.008. Chen YS, Wang XX, Shang PH. The study of tendency of hepatitis B virus surface antigen in Chinese population[J]. Chin J Exp Clin Infect Dis (Electronic Version), 2007, 1(1): 20-21. DOI: 10.3969/j.issn.1674-1358.2007.01.008.
[12]	Xia GL, Liu CB, Cao HL, et al. Prevalence of hepatitis B and C virus infections in the general Chinese population. Results from a nationwide cross-sectional seroepidemiologic study of hepatitis A, B, C, D, and E virus infections in China, 1992[J]. International Hepatology Communications, 1996, 5(1): 62-73. DOI: 10.1016/S0928-4346(96)82012-3.
[13]	Liang XF, Bi SL, Yang WZ, et al. Epidemiological serosurvey of hepatitis B in China--declining HBV prevalence due to hepatitis B vaccination[J]. Vaccine, 2009, 27(47): 6550-6557. DOI: 10.1016/j.vaccine.2009.08.048.
[14]	Dienstag JL. Hepatitis B virus infection[J]. N Engl J Med, 2008, 359(14): 1486-1500. DOI: 10.1056/NEJMra0801644.
[15]	Polaris Observatory HCV Collaborators. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study[J]. Lancet Gastroenterol Hepatol, 2017, 2(3): 161-176. DOI: 10.1016/S2468-1253(16)30181-9.
[16]	Botelho-Souza LF, Vasconcelos MPA, Dos Santos AO, et al. Hepatitis delta: virological and clinical aspects[J]. Virol J, 2017, 14(1): 177. DOI: 10.1186/s12985-017-0845-y.
[17]	Stockdale AJ, Kreuels B, Henrion MYR, et al. The global prevalence of hepatitis D virus infection: Systematic review and meta-analysis[J]. J Hepatol, 2020, 73(3): 523-532. DOI: 10.1016/j.jhep.2020.04.008.
[18]	Li PF, Liu JY, Li Y, et al. The global epidemiology of hepatitis E virus infection: A systematic review and meta-analysis[J]. Liver Int, 2020, 40(7): 1516-1528. DOI: 10.1111/liv.14468.
[19]	World Health Organization. Global hepatitis report, 2017[EB/OL]. (2017-01-01)[2021-05-01]. https://extranet.who.int/iris/restricted/bitstream/handle/10665/255016/9789241565455-eng.pdf.
[20]	Nayagam S, Thursz M, Sicuri E, et al. Requirements for global elimination of hepatitis B: a modelling study[J]. Lancet Infect Dis, 2016, 16(12): 1399-1408. DOI: 10.1016/S1473-3099(16)30204-3.
[21]	Singer AW, Reddy KR, Telep LE, et al. Direct-acting antiviral treatment for hepatitis C virus infection and risk of incident liver cancer: a retrospective cohort study[J]. Aliment Pharmacol Ther, 2018, 47(9): 1278-1287. DOI: 10.1111/apt.14593.
[22]	Tan MJ, Bhadoria AS, Cui FQ, et al. Estimating the proportion of people with chronic hepatitis B virus infection eligible for hepatitis B antiviral treatment worldwide: a systematic review and meta-analysis[J]. Lancet Gastroenterol Hepatol, 2021, 6(2): 106-119. DOI: 10.1016/S2468-1253(20)30307-1.
[23]	Zhang Q, Qi WQ, Wang X, et al. Epidemiology of hepatitis B and hepatitis C infections and benefits of programs for hepatitis prevention in Northeastern China: a cross-sectional study[J]. Clin Infect Dis, 2016, 62(3): 305-312. DOI: 10.1093/cid/civ859.