Elimination of Viral Hepatitis in Low and Middle-Income Countries: Epidemiological Research Gaps.
Elimination of Viral Hepatitis in Low and Middle-Income Countries: Epidemiological Research Gaps.
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DOI：
10.1007/s40471-021-00273-6
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发表时间：
2021-09
影响因子：
3.3
通讯作者：
Wandeler G
中科院分区：
文献类型：
--
作者：
Jaquet A;Muula G;Ekouevi DK;Wandeler G
我们综述的目的是总结当前关于检测策略、抗病毒治疗资格和监测以及预防慢性乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）感染母婴传播的建议，并强调低收入和中等收入国家（LMIC）的主要研究差距，特别关注撒哈拉以南非洲（SSA）。虽然中低收入国家乙肝病毒和丙肝病毒感染流行率的数据不断增加，但目前对肝脏相关并发症以及治疗结果的了解仍然有限。此外，关于高流行地区大规模检测和管理策略的可行性和成本效益的信息非常少。政策相关数据在SSA尤其稀缺，该地区占全球慢性病毒性肝炎负担的很大一部分。目前关于慢性病毒性肝炎管理和监测的建议主要依赖于高收入环境的数据。只有实施针对特定中低收入国家的预防、检测和治疗策略，才能实现全球消除病毒性肝炎。为了提供可扩展且具有成本效益的干预措施，必须采取专门的研究举措。未来的研究必须包括创新测试策略的评估、诊断肝硬化和肝细胞癌的简化方法的验证以及长期治疗结果和毒性的监测。此外，迫切需要制定消除乙型肝炎母婴传播的国家计划，包括对孕妇进行有效检测、对符合条件的孕妇进行治疗，并确保对所有新生儿进行出生剂量疫苗接种。
The purpose of our review was to summarize current recommendations on testing strategies, antiviral therapy eligibility and monitoring, and prevention of mother-to-child transmission of chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, and to highlight major research gaps in low and middle-income countries (LMIC), with a particular focus on sub-Saharan Africa (SSA). While data on the prevalence of HBV and HCV infections in LMIC are increasing, current knowledge on liver-related complications as well as on treatment outcomes remains limited. Furthermore, very little information is available on the feasibility and cost-effectiveness of large-scale testing and management strategies in high-prevalence settings. The availability of policy-relevant data is particularly scarce in SSA, which accounts for a significant part of the global burden of chronic viral hepatitis. Current recommendations on the management and monitoring of chronic viral hepatitis rely mainly on data from high-income settings. The global elimination of viral hepatitis will only be achieved if prevention, testing, and treatment strategies tailored to specific LMIC are implemented. In order to inform scalable and cost-effective interventions, dedicated research initiatives have to be undertaken. Future studies will have to include the evaluation of innovative testing strategies, the validation of simplified methods to diagnose liver cirrhosis and hepatocellular carcinoma, and the monitoring of long-term treatment outcomes and toxicity. In addition, national plans to achieve the elimination of HBV mother-to-child transmission are urgently needed, including effective ways to test pregnant women, treat those who are eligible, and ensure birth dose vaccination is given to all newborns.
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DOI：
10.1111/add.14393
发表时间：
2019-01
期刊：
Addiction (Abingdon, England)
影响因子：
--
作者：
Grebely J;Larney S;Peacock A;Colledge S;Leung J;Hickman M;Vickerman P;Blach S;Cunningham EB;Dumchev K;Lynskey M;Stone J;Trickey A;Razavi H;Mattick RP;Farrell M;Dore GJ;Degenhardt L
通讯作者：
Degenhardt L
影响因子：
25.7
作者：
Aberra, Hanna;Desalegn, Hailemichael;Johannessen, Asgeir
通讯作者：
Johannessen, Asgeir
影响因子：
35.7
作者：
Gupta, Neil;Mbituyumuremyi, Aimable;Grant, Philip M.
通讯作者：
Grant, Philip M.
影响因子：
6.7
作者：
Buti, Maria;Riveiro-Barciela, Mar;Esteban, Rafael
通讯作者：
Esteban, Rafael
影响因子：
3.3
作者：
Debes, Jose D.;Kayandabila, Johnstone;Pogemiller, Hope
通讯作者：
Pogemiller, Hope