丙肝的现状和诊治进展.ppt

嫩江县病毒性肝炎的发病率始终位居前三位。 吉林扶余县更新乡参加某项研究的HCV感染率为49.4%，约是全国HCV感染的15.44倍，是我国丙型肝炎的高发区。安纳咖注射人群是扶余县更新乡农村HCV感染的高危人群，是当地HCV感染的主要传播途径。扶余县更新乡面临丙型肝炎高感染率和低发现率、低治疗率的严峻挑战，应采取积极措施，努力减轻患病者的经济负担。 辽宁建平县丙型肝炎发病率、肝硬化和肝细胞癌死亡率水平异常增高，均显著高于辽宁省同期平均水平。 在广东河源、福建莆田、河北宽城等地区，普通人群中丙肝的患病率均远远高于强的流行率。究其原因，多数是因为不安全注射，共用注射器导致丙肝病毒在人群中传播。 安徽涡阳县丙肝聚集性疫情，经查证实，感染者均在河南永城市马桥镇一个体诊所接受过静脉推注治疗，疫情可能是由不安全注射引起。 贵州省黔南布依族苗族自治州平塘县人民医院在《中华人民共和国献血法》出台后，仍非法采血长达4年多时间，导致一丙肝感染者血液造成64人感染。 * * References Negro and Alberti. Liver Int. 2011;31(suppl 2):1. Kamal et al. Gut. 2005;54:858. Legrand-Abravanel et al. J Med Virol. 2009;81:2029. El-Serag. Gastroenterology. 2012;142:1264. Poordad et al. Gastroenterology. 2012;143:608. McHutchison et al. N Engl J Med. 2009;361:580. Ghany et al. Hepatology. 2009;49:1335. Ferenci et al. Hepatology. 2008;47:1816. Gao et al. Nature. 2010;465:96. Here we provide the first comprehensive survey of these trends. To approximate national HCV genotype prevalence, studies published between 1989 and 2013 reporting HCV genotypes are reviewed and combined with overall HCV prevalence estimates from the Global Burden of Disease (GBD) project. We also generate regional and global genotype prevalence estimates, inferring data for countries lacking genotype information. We include 1,217 studies in our analysis, representing 117 countries and 90% of the global population. We calculate that HCV genotype 1 is the most prevalent worldwide, comprising 83.4 million cases (46.2% of all HCV cases), approximately one-third of which are in East Asia. Genotype 3 is the next most prevalent globally (54.3 million, 30.1%); genotypes 2, 4, and 6 are responsible for a total 22.8% of all cases; genotype 5 comprises the remaining 1%. While genotypes 1 and 3 dominate in most countries irrespective of economic status, the largest proportions of genotypes 4 and 5 are in lower-income countries. Conclusion: Although genotype 1 is most common worldwide, nongenotype 1 HCV cases—which are less well served by advances in vaccin