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丙型肝炎病毒的当代见解:全面综述

Contemporary Insights into Hepatitis C Virus: A Comprehensive Review.

作者信息

Sallam Malik, Khalil Roaa

机构信息

Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan.

Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan.

出版信息

Microorganisms. 2024 May 21;12(6):1035. doi: 10.3390/microorganisms12061035.

Abstract

Hepatitis C virus (HCV) remains a significant global health challenge. Approximately 50 million people were living with chronic hepatitis C based on the World Health Organization as of 2024, contributing extensively to global morbidity and mortality. The advent and approval of several direct-acting antiviral (DAA) regimens significantly improved HCV treatment, offering potentially high rates of cure for chronic hepatitis C. However, the promising aim of eventual HCV eradication remains challenging. Key challenges include the variability in DAA access across different regions, slightly variable response rates to DAAs across diverse patient populations and HCV genotypes/subtypes, and the emergence of resistance-associated substitutions (RASs), potentially conferring resistance to DAAs. Therefore, periodic reassessment of current HCV knowledge is needed. An up-to-date review on HCV is also necessitated based on the observed shifts in HCV epidemiological trends, continuous development and approval of therapeutic strategies, and changes in public health policies. Thus, the current comprehensive review aimed to integrate the latest knowledge on the epidemiology, pathophysiology, diagnostic approaches, treatment options and preventive strategies for HCV, with a particular focus on the current challenges associated with RASs and ongoing efforts in vaccine development. This review sought to provide healthcare professionals, researchers, and policymakers with the necessary insights to address the HCV burden more effectively. We aimed to highlight the progress made in managing and preventing HCV infection and to highlight the persistent barriers challenging the prevention of HCV infection. The overarching goal was to align with global health objectives towards reducing the burden of chronic hepatitis, aiming for its eventual elimination as a public health threat by 2030.

摘要

丙型肝炎病毒(HCV)仍然是一项重大的全球健康挑战。截至2024年,据世界卫生组织统计,约有5000万人患有慢性丙型肝炎,这在很大程度上导致了全球的发病率和死亡率。几种直接作用抗病毒药物(DAA)疗法的出现和获批显著改善了HCV的治疗,为慢性丙型肝炎提供了潜在的高治愈率。然而,最终根除HCV这一充满希望的目标仍然具有挑战性。主要挑战包括不同地区DAA可及性的差异、不同患者群体以及HCV基因型/亚型对DAA的反应率略有不同,以及耐药相关替代突变(RAS)的出现,这可能导致对DAA产生耐药性。因此,需要定期重新评估当前关于HCV的知识。基于观察到的HCV流行病学趋势的变化、治疗策略的持续发展和获批情况以及公共卫生政策的变化,对HCV进行最新综述也很有必要。因此,本次全面综述旨在整合关于HCV的流行病学、病理生理学、诊断方法、治疗选择和预防策略的最新知识,特别关注与RAS相关的当前挑战以及疫苗研发的持续努力。本综述旨在为医疗保健专业人员、研究人员和政策制定者提供必要的见解,以便更有效地应对HCV负担。我们旨在强调在管理和预防HCV感染方面取得的进展,并突出挑战HCV感染预防的持续障碍。总体目标是与全球卫生目标保持一致,以减轻慢性肝炎的负担,目标是到2030年最终消除其作为公共卫生威胁的状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a834/11205832/38c4b3dffe37/microorganisms-12-01035-g001.jpg

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