2016年澳大利亚丙型肝炎病毒感染诊治指南及各国指南之对比解读——Ⅰ.筛查、诊断及治疗前评估  

Introduction of 2016 Australian consensus for the management of hepatitis C virus infection and comparison with other:guidelines:Ⅰ. the screening, diagnosis, and pre-treatment assessment

作　　者：刘姝[1] 王炳元[1] 乔梁[2] 

机构地区：[1]中国医科大学附属第一医院老年消化科,辽宁沈阳110001 [2]悉尼大学Westmead医学研究所Storr肝病研究中心

出　　处：《兰州大学学报（医学版）》2016年第6期73-77,共5页Journal of Lanzhou University（Medical Sciences）

摘　　要：2016年澳大利亚胃肠病学会等多家机构组织专家联合撰写并发布了《2016年澳大利亚丙型肝炎病毒(HCV)感染诊治指南》,内容涉及澳大利亚HCV感染的流行现状及管理模式、丙型肝炎病毒(hepatitis C virus,HCV)感染的筛查及诊断、治疗前评估、治疗方案选择、治疗期间监测及治疗后随访等,本文对其中的部分要点进行解读,并着重与《2015年中国丙型肝炎防治指南》、《2016年欧洲肝病学会丙型肝炎治疗指南》、《2015年加拿大肝病学会慢性丙型肝炎管理共识指南》、《2015及2016年美国肝病学会丙型肝炎治疗指南》、《2016年英国HCV感染诊治指南》以及《2016年世界卫生组织丙型肝炎治疗指南》中的相应内容进行比较,以期为临床肝病医生了解各个指南推荐意见的异同、规范HCV感染的临床诊治提供便利。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 failure if left untreated. In certain western countries such as Australia, HCV-related ESLDs are among the most common indications of liver transplantation. As prevention of HCV infection through vaccination isnot yet available, proper management for HCV infection is of paramount importance in preventing the devel- opment 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 pegylat- ed interferon a 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 re- gions. In China's Mainland, 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 Austral

关 键 词：病毒性肝炎 丙型肝炎病毒 指南 共识 筛查 诊断 治疗前评估 对比解读 

分 类 号：R446.5[医药卫生—诊断学]