Global challenges in liver disease
Global challenges in liver disease
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DOI：
10.1002/hep.21347
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发表时间：
2006-09-01
期刊：
影响因子：
13.5
通讯作者：
Williams, Roger
中科院分区：
文献类型：
--
作者：
Williams, Roger
移民、廉价航空旅行和全球化都是导致乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）感染在全球传播的因素。由于HBV/HCV合并感染而导致的终末期慢性肝病（ESLD）现在是艾滋病毒感染者死亡的主要原因。埃及丙型肝炎病毒感染的高发病率——与其他高流行地区一样，大量使用吐酒石根除血吸虫病所遗留下来的问题——将需要数年时间才能降低。由于全球人口肥胖水平的上升，非酒精性脂肪性肝病引起的脂肪性肝炎正在发展成为一个新的重大健康问题。肝脂肪变性对其他肝脏疾病的进展也有不利影响，包括慢性丙型肝炎病毒感染和酒精性肝病。在许多国家，由于酒精消费水平的增加对较年轻和富裕的年龄组产生不利影响，公众的关注程度正在上升。随着肝硬化患病率的上升，原发性肝细胞癌（HCC）和原发性肝内胆管癌的发生频率也在增加。最后，尽管肝移植取得了成功，但由于许多国家的尸体器官捐献水平较低，许多值得移植的患者没有得到移植，从而增加了使用活体肝脏移植的压力。只有通过各国政府、卫生机构、各级卫生保健专业人员和制药行业的共同努力，才能扭转全球肝病的严峻前景。
Immigration, cheap air travel, and globalization are all factors contributing to a worldwide spread of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. End-stage chronic liver disease (ESLD) as a result of co-infection with HBV/HCV is now the major cause of death for individuals who have been infected with the HIV virus. The high incidence of HCV infection in Egypt-the legacy left from the mass use of tartar emetic to eradicate schistosomiasis, as in other high prevalence areas-will take years to reduce. Steatohepatitis due to non-alcoholic fatty liver disease is developing into a new and major health problem as a result of rising levels of obesity in populations worldwide. Hepatic steatosis also has an adverse influence on the progression of other liver diseases including chronic HCV infection and alcoholic liver disease. In many countries, considerable public concern is on the rise due to increased levels of alcohol consumption adversely affecting younger and affluent age groups. With the rising prevalence of cirrhosis, primary hepatocellular carcinoma (HCC) is increasing in frequency as is that of primary intrahepatic cholangiocarcinoma. Finally, despite the successes of liver transplantation, many deserving patients are not getting transplants due to low levels of cadaver organ donation in many countries, thereby increasing pressures on the use of living donor liver transplantation. Only through a concerted effort from governments, health agencies, healthcare professionals at all levels, and the pharmaceutical industry can this grim outlook for liver disease worldwide be reversed.