Estimating the proportion of people with chronic hepatitis B virus infection eligible for hepatitis B antiviral treatment worldwide: a systematic review and meta-analysis.
Estimating the proportion of people with chronic hepatitis B virus infection eligible for hepatitis B antiviral treatment worldwide: a systematic review and meta-analysis.
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估计全世界慢性乙肝病毒感染者有资格接受乙肝抗病毒治疗的比例：一项系统回顾和荟萃分析。
DOI：
10.1016/s2468-1253(20)30307-1
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Hutin Y
中科院分区：
文献类型：
--
作者：
Tan M;Bhadoria AS;Cui F;Tan A;Van Holten J;Easterbrook P;Ford N;Han Q;Lu Y;Bulterys M;Hutin Y
2016年，在全球约2.57亿慢性B型肝炎病毒（HBV）感染者中，只有一小部分人得到诊断和治疗。关于有资格接受治疗的HBV感染者比例的信息不足限制了对全球治疗覆盖率的解释。我们的目的是根据WHO 2015年指南，估计全球有资格接受抗病毒治疗的慢性HBV感染者的比例。在这项系统性综述和荟萃分析中，我们检索了Medline、EMBASE和科克伦数据库，从2007年1月1日至2018年1月31日，寻找描述人群或医疗机构中HBsAg阳性人群的研究。我们使用标准化表格从已发表的研究中提取信息，以估计肝硬化、丙氨酸氨基转移酶（ALT）异常、HBV DNA超过2000 IU/mL或20 000 IU/mL的频率、HBeAg的存在以及研究中报告的WHO和其他指南规定的治疗资格。 我们通过随机效应的荟萃分析汇总了比例。本研究已在PROSPERO注册，CRD 42020132345。在13497项研究中，162项符合条件并纳入我们的分析。 这些研究包括145789名参与者。 肝硬化比例的汇总估计值为9%（95%CI 8-10），范围从社区环境中的6%（4-8）到诊所环境中的10%（9-11）。检查具有WHO指南中用于确定合格性的特征的参与者的比例，17394人中有1750人（10.1%）HBV DNA超过20000 IU/mL，66235人中有20425人（30.8%）ALT高于正常上限。 32项研究根据WHO或任何其他指南报告了治疗的合格性，合格性的汇总估计值为19%（95% CI 18-20），范围从社区环境研究的12%（6-18）到诊所环境的25%（19-30）。许多研究描述了HBV感染者，但很少有报告信息的方式，允许评估治疗的资格。虽然在2.57亿HBV感染者中，约有十分之一（2600万）可能因肝硬化而急需治疗，但根据不同的指南，更大比例（12-25%）有资格接受治疗。根据广泛认可的定义，未来描述HBV感染者的研究应报告治疗资格。世卫组织和美国疾病控制和预防中心。
In 2016, of the estimated 257 million people living with chronic hepatitis B virus (HBV) infection worldwide, only a small proportion was diagnosed and treated. The insufficiency of information on the proportion of people infected with HBV who are eligible for treatment limits the interpretation of global treatment coverage. We aimed to estimate the proportion of people with chronic HBV infection who were eligible for antiviral treatment worldwide, based on the WHO 2015 guidelines. In this systematic review and meta-analysis, we searched Medline, EMBASE, and the Cochrane databases from Jan 1, 2007, to Jan 31, 2018, for studies describing HBsAg-positive people in the population or health-care facilities. We extracted information from published studies using a standardised form to estimate the frequency of cirrhosis, abnormal alanine aminotransferase (ALT), HBV DNA exceeding 2000 IU/mL or 20 000 IU/mL, presence of HBeAg, and eligibility for treatment as per WHO and other guidelines as reported in the studies. We pooled proportions through meta-analysis with random effects. The study was registered with PROSPERO, CRD42020132345. Of the 13 497 studies, 162 were eligible and included in our analysis. These studies included 145 789 participants. The pooled estimate of the proportion of cirrhosis was 9% (95% CI 8–10), ranging from 6% (4–8) in community settings to 10% (9–11) in clinic settings. Examining the proportion of participants who had characteristics used to determine eligibility in the WHO guidelines, 1750 (10·1%) of 17 394 had HBV DNA exceeding 20 000 IU/mL, and 20 425 (30·8%) of 66 235 had ALT above the upper limit of normal. 32 studies reported eligibility for treatment according to WHO or any other guidelines, with a pooled estimate of eligibility at 19% (95% CI 18–20), ranging from 12% (6–18) for studies in community settings to 25% (19–30) in clinic settings. Many studies described people with HBV infection, but few reported information in a way that allowed assessment of eligibility for treatment. Although about one in ten of the 257 million people with HBV infection (26 million) might be in urgent need of treatment because of cirrhosis, a larger proportion (12–25%) is eligible for treatment in accordance with different guidelines. Future studies describing people with HBV infection should report on treatment eligibility, according to broadly agreed definitions. WHO and US Centers for Disease Control and Prevention.
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影响因子：
0.6
作者：
Al-Hanafi N;Monem F
通讯作者：
Monem F
影响因子：
0.6
作者：
Chen P;Yu C;Wu W;Wang J;Ruan B;Ren J;Yang S;Xu K;Yu L;Li L
通讯作者：
Li L
DOI：
10.4103/1319-3767.37796
发表时间：
2008-01
期刊：
Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association
影响因子：
--
作者：
Alam S;Ahmad N;Mustafa G;Alam K;Khan M
通讯作者：
Khan M
影响因子：
--
作者：
Conde SR;Rocha LL;Ferreira VM;Monteiro JC;Filgueiras NK;Lins PA;dos Santos BT;Freitas FB;Graça Eda S;Demachki S;de Araújo MT;Ishak R;Vallinoto AC
通讯作者：
Vallinoto AC