NAT REV GASTRO HEPAT:病毒性肝炎诊断过晚或引起可怕后果

2019-07-29 Daphné MedSci原创

Nature Reviews Gastroenterology & Hepatology 7月新发表的一篇评论称乙肝病毒和丙肝病毒的治疗普遍偏迟,影响了全球肝病的发病率和死亡率。为了改变这一现象,需促进早期病毒性肝炎的检测。世界卫生组织估计,全球有2.51亿人患有慢性乙肝,丙肝则有0.71亿人,分别占世界人口的3.5%和1.0%。2016年,死于丙肝和乙肝的人数为130万人,占病毒性肝炎死

Nature Reviews Gastroenterology & Hepatology 7月新发表的一篇评论称乙肝病毒和丙肝病毒的治疗普遍偏迟,影响了全球肝病的发病率和死亡率。为了改变这一现象,需促进早期病毒性肝炎的检测。

世界卫生组织估计,全球有2.51亿人患有慢性乙肝,丙肝则有0.71亿人,分别占世界人口的3.5%和1.0%。2016年,死于丙肝和乙肝的人数为130万人,占病毒性肝炎死亡率的96%。
然而大部分的慢性乙肝和丙肝感染者尚未确诊(分别为91%和80%),已经确诊的人群中很多已进展为晚期肝病。

对于感染性疾病来说,诊断和治疗的延迟对个体和人群健康都有巨大的危害。首先,未经治疗的个体存在病毒毒性导致HBV和HCV发病率增加,其次,近些年的研究表明,约30%治疗较晚的病毒性肝炎患者从抗病毒治疗中获益少,这些人有发展为肝硬化失代偿期、门静脉高压和肝癌的高风险。

对于感染个体,治疗一旦达到病毒抑制状态,感染个体将不再传播病毒。另有研究证明,及早治疗能改善病毒性肝炎的结局,比如说提高移植后生存率。

这篇评论表示解决诊断和治疗过晚的方法或许很简单——早期检测的发展,扩大实验室血清学检测的同时,也需在社区设置快速检测。如果不能解决诊断和治疗过晚的问题,乙肝和丙肝的发病率和死亡率将继续有增无减。

原始出处:Too many people with viral hepatitis are diagnosed late — with dire consequences,Nature Reviews Gastroenterology & Hepatologyvolume 16, pages451–452 (2019) https://www.nature.com/articles/s41575-019-0177-z

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    2019-12-15 liye789132251
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    2020-04-01 许安
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    2019-11-01 howi
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    2019-07-31 gwc384

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