Micro-elimination of hepatitis C virus.

World Health Organization direct-acting antivirals elimination hepatitis C virus

Journal

Liver international : official journal of the International Association for the Study of the Liver
ISSN: 1478-3231
Titre abrégé: Liver Int
Pays: United States
ID NLM: 101160857

Informations de publication

Date de publication:
02 2020
Historique:
received: 26 12 2019
accepted: 27 12 2019
entrez: 21 2 2020
pubmed: 23 2 2020
medline: 22 6 2021
Statut: ppublish

Résumé

HCV affects about 71 million people worldwide with 1.75 million new infections a year, mainly associated with healthcare, blood transfusion before screening of donors and drug use. Hepatitis C is a systemic disease with hepatic and extrahepatic manifestations resulting in increased morbidity and mortality in HCV-infected patients compared to cured or uninfected individuals. The goal of eliminating hepatitis C by 2030 is based on the following three main actions: strengthening and increasing outreach screening; increasing access to treatment; and improving prevention. Although the tools and the targets of HCV elimination have now been well established, micro-elimination, a cure in high-risk populations, is possible, but has not been achieved. These populations are mainly migrants, prisoners, drug users, HIV co-infected patients and psychiatric patients. New tools must be developed to achieve micro-elimination, in particular, rapid diagnostic orientation tests for better screening, delocalization of healthcare services to improve access to care, and training physicians to raise awareness of the disease, increase understanding of its pathogenesis and provide information on the availability of safe and effective treatment to cure chronic infection and reverse hepatic and extrahepatic manifestations. Thus, while the goal of complete elimination of hepatitis C virus was feasible in Western countries, it was more difficult in high-prevalence countries where improvement in the detection of chronic infection (with rapid serological and virological diagnostic tests), outsourcing of diagnostic and therapeutic care and access to direct oral antivirals are urgently needed.

Sections du résumé

BACKGROUND & AIMS
HCV affects about 71 million people worldwide with 1.75 million new infections a year, mainly associated with healthcare, blood transfusion before screening of donors and drug use. Hepatitis C is a systemic disease with hepatic and extrahepatic manifestations resulting in increased morbidity and mortality in HCV-infected patients compared to cured or uninfected individuals.
RESULTS
The goal of eliminating hepatitis C by 2030 is based on the following three main actions: strengthening and increasing outreach screening; increasing access to treatment; and improving prevention. Although the tools and the targets of HCV elimination have now been well established, micro-elimination, a cure in high-risk populations, is possible, but has not been achieved. These populations are mainly migrants, prisoners, drug users, HIV co-infected patients and psychiatric patients. New tools must be developed to achieve micro-elimination, in particular, rapid diagnostic orientation tests for better screening, delocalization of healthcare services to improve access to care, and training physicians to raise awareness of the disease, increase understanding of its pathogenesis and provide information on the availability of safe and effective treatment to cure chronic infection and reverse hepatic and extrahepatic manifestations.
CONCLUSION
Thus, while the goal of complete elimination of hepatitis C virus was feasible in Western countries, it was more difficult in high-prevalence countries where improvement in the detection of chronic infection (with rapid serological and virological diagnostic tests), outsourcing of diagnostic and therapeutic care and access to direct oral antivirals are urgently needed.

Identifiants

pubmed: 32077601
doi: 10.1111/liv.14363
doi:

Substances chimiques

Antiviral Agents 0

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

67-71

Informations de copyright

© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Références

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Auteurs

Clémence Hollande (C)

Département d'Hépatologie, Université Paris Centre, Hôpital Cochin, APHP, INSERM U1223, Institut Pasteur, Paris, France.

Lucia Parlati (L)

Département d'Hépatologie, Université Paris Centre, Hôpital Cochin, APHP, INSERM U1223, Institut Pasteur, Paris, France.

Stanislas Pol (S)

Département d'Hépatologie, Université Paris Centre, Hôpital Cochin, APHP, INSERM U1223, Institut Pasteur, Paris, France.

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