The removal of DAA restrictions in Europe - One step closer to eliminating HCV as a major public health threat
The removal of DAA restrictions in Europe - One step closer to eliminating HCV as a major public health threat
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DOI：
10.1016/j.jhep.2018.06.016
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发表时间：
2018-11-01
影响因子：
25.7
通讯作者：
Grebely, Jason
中科院分区：
文献类型：
--
作者：
Marshall, Alison D.;Pawlotsky, Jean-Michel;Grebely, Jason
在欧洲1020万慢性丙型肝炎病毒感染者中，670万人生活在东欧，230万人生活在西欧，120万人生活在中欧。丙型肝炎病毒传播继续与丙型肝炎病毒相关的肝病负担增加同时发生，这是几十年前丙型肝炎病毒流行高峰期感染人口老龄化的结果。2016年，世界卫生组织制定了到2030年消除丙型肝炎病毒感染这一主要公共卫生威胁的目标。在整个欧洲，估计有36%的慢性丙型肝炎病毒感染者得到了诊断，大约5%的人得到了治疗。提高丙型肝炎病毒治疗接受率的一个主要障碍是，由于直接作用抗病毒(DAA)疗法最初标价较高，支付方(包括各国政府和其他方面)设置了限制。这篇文章的目的是讨论欧洲的DAA限制，为什么DAA限制仍然有效，是什么促进了DAA限制的取消，以及在我们试图到2030年消除作为该地区主要公共卫生威胁的丙型肝炎的过程中仍然存在哪些挑战。(C)2018年欧洲肝脏研究协会。爱思唯尔出版，版权所有。
Of similar to 10.2 million people with chronic HCV infection in Europe, 6.7 million live in Eastern Europe, 2.3 million in Western Europe and 1.2 million in Central Europe.HCV transmission continues to occur in parallel with an increasing HCV-related liver disease burden, the result of an ageing population infected during peak HCV epidemics decades earlier. In 2016, the World Health Organization set targets to eliminate HCV infection as a major public health threat by 2030. Across Europe, an estimated 36% of those living with chronic HCV infection have been diagnosed and similar to 5% have been treated. A major barrier to enhancing HCV treatment uptake has been restrictions set by payers, including national governments and others, in response to the initially high list prices of direct-acting antiviral (DAA) therapies. The aims of this article are to discuss DAA restrictions in Europe, why DAA restrictions are still in place, what has facilitated the removal of DAA restrictions, and what challenges remain as we attempt to eliminate HCV as a major public health threat in the region by 2030. (C) 2018 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.