摘要
Abstract
Hepatitis C virus (HCV) infection is a common health problem worldwide and it is estimated that approximately 110 million people (or 1.7％ of world population) are infected with HCV but most of them are unaware of their infection. The reported prevalence rate for chronic HCV infection in China was 0.43％ (being close to 10 million people). HCV infection is a well-recognized risk factor for chronic liver diseases and will likely evolve into end stage liver diseases (ESLDs) such as cirrhosis, hepatocellular carcinoma (HCC) and liver most common indications of liver transplantation. As prevention of HCV infection through vaccination is not yet available, proper management for HCV infection is of paramount importance in preventing the development of HCV- related liver diseases in the infected individuals. The advent of direct- acting antiviral (DAA) agents has revolutionized the treatment approaches for HCV infection. Compared to the conventional pegylated interferon α and ribavirin (PegIFN/RBV)-based treatment regimens which often have limited efficacy with poor tolerability, DAAs are more effective in achieving sustained virological response (SVR) and are much better-tolerated. Studies have also shown DAAs are superior to the conventional treatments in reversing liver fibrosis, regressing liver cirrhosis, and reducing the risk of HCC development. However, the high cost of DAAs may limit these agents from being widely used in all HCV infected individuals in all geographic regions. In mainland China, DAAs are currently unavailable and will likely remain unavailable for many years to come. As such, combination of the interferon-and ribavirin-based regimens remains the mainstream therapy for HCV-infected individuals in China as recommended by the most recent Chinese consensus statement for the management of HCV infection (2015 edition). In contrast, the newly released Australian consensus for the management of HCV infection recommends DAAs be used in all HCV infected people in all communities through the Pharmaceutical Benefits Scheme (PBS). Notably, the currently available guidelines for the management of HCV infection from different countries/organizations may vary in several aspects possibly reflecting the underlying variations of HCV genotype distribution, epidemiological features, and the availability of reliable medical social welfare systems. This article aims to compare the recently released Australian consensus for the management of HCV infection to the guidelines of China and several other countries/organizations in order to bring to the readers important considerations in the management of HCV patients. In the first part of the series, various guidelines for the screening, diagnosis, and pre-treatment assessment for the HCV infected individuals are compared.关键词
病毒性肝炎/丙型肝炎病毒/指南/共识/治疗方案选择/治疗期间监测/治疗后随访/对比解读Key words
viral hepatitis/hepatitis C virus/guideline/consensus/treatment options/monitoring during treatment/follow up after treatment/comparison分类
医药卫生
