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Hepatitis C

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LANCET
卷 394, 期 10207, 页码 1451-1466

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ELSEVIER SCIENCE INC
DOI: 10.1016/S0140-6736(19)32320-7

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Hepatitis C is a global health problem, and an estimated 71.1 million individuals are chronically infected with hepatitis C virus (HCV). The global incidence of HCV was 23.7 cases per 100 000 population (95% uncertainty interval 21.3-28.7) in 2015, with an estimated 1.75 million new HCV infections diagnosed in 2015. Globally, the most common infections are with HCV genotypes 1 (44% of cases), 3 (25% of cases), and 4 (15% of cases). HCV transmission is most commonly associated with direct percutaneous exposure to blood, via blood transfusions, health-care-related injections, and injecting drug use. Key high-risk populations include people who inject drugs, men who have sex with men, and prisoners. Approximately 10-20% of individuals who are chronically infected with HCV develop complications, such as cirrhosis, liver failure, and hepatocellular carcinoma over a period of 20-30 years. Direct-acting antiviral therapy is now curative, but it is estimated that only 20% of individuals with hepatitis C know their diagnosis, and only 15% of those with known hepatitis C have been treated. Increased diagnosis and linkage to care through universal access to affordable point-of-care diagnostics and pangenotypic direct-acting antiviral therapy is essential to achieve the WHO 2030 elimination targets.

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