在艾滋病毒感染者中消除C型肝炎:进展,差距和未来方向
Pablo Ryan1,2,3,4, Juan Berenguer2,3,5
1Hospital Universitario Infanta Leonor.
Current opinion in HIV and AIDS
|November 28, 2025
概括
直接作用抗病毒药物 (DAA) 为艾滋病毒感染者 (PWH) 提供高的C型肝炎病毒 (HCV) 治愈率. 然而,全球消除HCV面临的挑战是由于接入,成本和耻辱,特别是在低收入国家.
科学领域:
- 肝病学和传染病的研究
- 公共卫生和流行病学
- 艾滋病毒/艾滋病管理
背景情况:
- 艾滋病毒感染者 (PWH) 患有较高的C型肝炎病毒 (HCV) 流行率和更快的疾病进展.
- 由于与艾滋病毒治疗的联系,HCV消除策略优先考虑PWH.
- 直接作用抗病毒药物 (DAA) 已经彻底改变了HCV治疗.
研究的目的:
- 审查当前关于专门针对艾滋病毒感染者的HCV消除策略的证据.
- 突出取得的成果,确定持续存在的差距,并概述在PWH中消除HCV的未来方向.
- 评估世界卫生组织 (WHO) 在这一群体中实现HCV消除目标的进展情况.
主要方法:
- 对艾滋病毒感染者的HCV治疗和消除研究的综合文献综述.
- 分析来自高收入和中低收入国家的数据.
- 综合关于DAA疗效,治疗吸收和护理障碍的证据.
主要成果:
- 在PWH中,DAA可以达到95%以上的HCV治愈率,而泛型疗法可以更好地融入HIV服务.
- 高收入国家在PWH中显示出HCV病毒性病的显著下降,在某些地区接近微分泌.
- 由于成本和结构性障碍,低收入国家的治疗机会仍然有限;重感染在与男性发生性关系的男性 (MSM) 和注射毒品的人 (PWID) 等关键人群中持续存在.
结论:
- 对于艾滋病毒感染者来说,在资源充足的环境中,可以实现HCV消除,但全球进展不一致.
- 解决获得DAA的差异,实施普遍查和加强降低伤害服务至关重要.
- 持续的政治承诺和综合护理模式对于防止挫折和实现全球HCV消除目标至关重要.
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