中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

消除乙型肝炎进展

庄辉

引用本文:
Citation:

消除乙型肝炎进展

DOI: 10.12449/JCH240501
利益冲突声明:本文不存在任何利益冲突。
详细信息
    通信作者:

    庄辉, zhuangbmu@126.com (ORCID: 0000-0001-9119-6325)

Progress towards elimination of hepatitis B

More Information
    Corresponding author: ZHUANG Hui, zhuangbmu@126.com (ORCID: 0000-0001-9119-6325)
  • 摘要: 本文综述了全球和中国消除乙型肝炎的新进展。虽然全球乙型肝炎疾病负担正在下降,但各国消除乙型肝炎的进展差异较大,在疾病负担最严重的20个国家中,孟加拉国、印度、印度尼西亚、日本和俄罗斯取得显著进展。中国继续保持新生儿乙型肝炎疫苗高覆盖率,首剂及时接种率为95.6%,3剂接种率为99.6%。从2016年到2022年,中国慢性乙型肝炎患者的诊断率由19%升至24%,治疗率由11%升至15%,但与世界卫生组织提出的2023年目标仍有较大距离。全球和中国仍需继续努力,砥砺奋进,加速实现2030年消除病毒性肝炎的宏伟目标。

     

  • 图  1  2022年全球不同地区慢性乙型肝炎诊断率和治疗率Figure 1 Diagnosis and treatment rates of chronic hepatitis B in different regions of the world, 2022

    图  2  The Lancet Gastroenterology & Hepatology委员会对全球病毒性肝炎疾病负担最严重的20个国家2018—2023年消除病毒性肝炎相关政策的评分

    Figure  2.  The Lancet Gastroenterology & Hepatology Commission’s scores on policies related to the elimination of viral hepatitis from 2018 to 2023 for the 20 countries with the highest disease burden of viral hepatitis worldwide

    图  3  中国一般人群和<5岁儿童HBsAg流行率

    注: a,一般人群;b,<5岁儿童。

    Figure  3.  Prevalence of HBsAg in the general population and children aged <5 years in China

    图  4  我国乙型肝炎相关HCC年龄标化发病率变

    Figure  4.  Age-standardized incidence rates of hepatitis B-related HCC in China

    图  5  成人HBV筛查和筛查后评价、诊断、治疗和管理

    Figure  5.  HBV screening and post-screening evaluation, diagnosis, treatment, and management in adults

    表  1  全球消除乙型肝炎进展

    Table  1.   Worldwide progress in elimination of hepatitis B

    项目 2019年 2022年
    HBsAg阳性人数(例) 2.96亿 2.57亿
    一般人群HBsAg流行率 3.8% 3.2%
    <5岁HBsAg流行率 0.9% 0.7%(560万)
    死亡人数(例) 82万 无资料
    诊断人数(例) 3 040万 3 600万(14%)
    治疗人数(例) 660万 680万(8%)
    3针乙型肝炎疫苗覆盖率 86% 85%
    首针及时接种率 43% 46%
    HBIG接种率 13% 14%
    孕妇抗病毒预防率 <1% 3%
    注:HBIG,乙型肝炎免疫球蛋白。
    下载: 导出CSV

    表  2  2017—2023年美国消除乙型肝炎进展

    Table  2.   Progress in elimination of hepatitis B in the United States, 2017—2023

    表  3  2022年全球与中国消除乙型肝炎进展比较

    Table  3.   Comparison of progress in elimination of hepatitis B worldwide and in China, 2022

    项目 全球 中国
    HBsAg阳性人数(例) 2.57亿 7 975万
    一般人群HBsAg流行率 3.2% 5.6%
    <5岁HBsAg流行率 0.7%(560万) <0.1%(8万)
    死亡人数(例) 无资料 无资料
    诊断人数(例) 3 600万(14%) 1 913万(24%)
    治疗人数(例) 680万(8%) 508万(15%)
    3针乙型肝炎疫苗覆盖率 85% 99%
    首针及时接种率 46% 95%
    HBIG接种率 14% 100%
    孕妇抗病毒预防率 3% 26%
    下载: 导出CSV
  • [1] World Health Organization. Global hepatitis report, 2017[EB/OL]. https://www.who.int/hepatitis/publications/global-hepatitis-report2017/en/. https://www.who.int/hepatitis/publications/global-hepatitis-report2017/en/
    [2] World Health Organization. Global health sector strategies on, respectively, HIV, viral hepatitis and sexually transmitted infections for the period 2022- 2030[EB/OL]. https://cdn.who.int/media/docs/default-source/hq-hiv-hepatitis-and-stis-library/full-final-who-ghss-hiv-vh-sti_1-june2022.pdf?sfvrsn=7c074b36_9. https://cdn.who.int/media/docs/default-source/hq-hiv-hepatitis-and-stis-library/full-final-who-ghss-hiv-vh-sti_1-june2022.pdf?sfvrsn=7c074b36_9
    [3] World Health Organization. Global health sector strategy on viral hepatitis 2016- 2021: Towards ending viral hepatitis[EB/OL]. https://apps.who.int/iris/bitstream/10665/246177/1/WHO-HIV-2016.06-eng,pdf?ua= 1. https://apps.who.int/iris/bitstream/10665/246177/1/WHO-HIV-2016.06-eng
    [4] GBD 2019 Hepatitis B Collaborators. Global, regional, and national burden of hepatitis B, 1990-2019: A systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet Gastroenterol Hepatol, 2022, 7( 9): 796- 829. DOI: 10.1016/S2468-1253(22)00124-8.
    [5] CUI FQ, BLACH S, MANZENGO MINGIEDI C, et al. Global reporting of progress towards elimination of hepatitis B and hepatitis C[J]. Lancet Gastroenterol Hepatol, 2023, 8( 4): 332- 342. DOI: 10.1016/S2468-1253(22)00386-7.
    [6] COLLABORATORS PO. Global prevalence, cascade of care, and prophylaxis coverage of hepatitis B in 2022: A modelling study[J]. Lancet Gastroenterol Hepatol, 2023, 8( 10): 879- 907. DOI: 10.1016/S2468-1253(23)00197-8.
    [7] World Health Organization. Progress report on HIV, viral hepatitis and sexually transmitted infections 2021: accountability for the global health sector strategies, 2016-2021: actions for impact. Geneva: World Health Organization, 2021.
    [8] CDA Foundation. https://cdafound.org/dashboard/polaris/dashboard.html. https://cdafound.org/dashboard/polaris/dashboard.html
    [9] World Health Organization/UNICEF. WHO/UNICEF joint reporting process[EB/OL]. Geneva, 2019. https://www.who.int/treams/immunization- vaccines. https://www.who.int/treams/immunization- vaccines
    [10] COOKE GS, FLOWER B, CUNNINGHAM E, et al. Progress towards elimination of viral hepatitis: A Lancet Gastroenterology& Hepatology Commission update[J]. Lancet Gastroenterol Hepatol, 2024, 9( 4): 346- 365. DOI: 10.1016/S2468-1253(23)00321-7.
    [11] US Center for Disease Control and Prevention. 2023 Viral hepatitis national progress report. 2024[EB/OL]. https://www.cdc.gov/hepatitis/policy/npr/2023/index.htm https://www.cdc.gov/hepatitis/policy/npr/2023/index.htm
    [12] SU X, ZHENG L, ZHANG HM, et al. Secular trends of acute viral hepatitis incidence and mortality in China, 1990 to 2019 and its prediction to 2030: The global burden of disease study 2019[J]. Front Med(Lausanne), 2022, 9: 842088. DOI: 10.3389/fmed.2022.842088.
    [13] YUE TT, ZHANG QQ, CAI T, et al. Trends in the disease burden of HBV and HCV infection in China from 1990-2019[J]. Int J Infect Dis, 2022, 122: 476- 485. DOI: 10.1016/j.ijid.2022.06.017.
    [14] SHI JF, CAO MM, WANG YT, et al. Is it possible to halve the incidence of liver cancer in China by 2050?[J]. Int J Cancer, 2021, 148( 5): 1051- 1065. DOI: 10.1002/ijc.33313.
    [15] CUI FQ, SHEN LP, LI L, et al. Prevention of chronic hepatitis B after 3 decades of escalating vaccination policy, China[J]. Emerg Infect Dis, 2017, 23( 5): 765- 772. DOI: 10.3201/eid2305.161477.
    [16] LIANG X, BI SL, YANG WZ, et al. Epidemiological serosurvey of hepatitis B in China—declining HBV prevalence due to hepatitis B vaccination[J]. Vaccine, 2009, 27( 47): 6550- 6557. DOI: 10.1016/j.vaccine.2009.08.048.
    [17] LIU J, LIANG WN, JING WZ, et al. Countdown to 2030: Eliminating hepatitis B disease, China[J]. Bull World Health Organ, 2019, 97( 3): 230- 238. DOI: 10.2471/BLT.18.219469.
    [18] ZHANG GM, MIAO N, ZHENG H, et al. Incidence by age and region of hepatitis B reported in China from 2005 to 2016[J]. Chin J Vaccines Immun, 2018, 24( 2): 121- 126. DOI: 10.19914/j.cjvi.2018.02.001.

    张国民, 缪宁, 郑徽, 等. 中国2005—2016年乙型病毒性肝炎报告发病的年龄和地区特征[J]. 中国疫苗和免疫, 2018, 24( 2): 121- 126. DOI: 10.19914/j.cjvi.2018.02.001.
    [19] SO S, TERRAULT N, CONNERS EE. Universal adult hepatitis B screening and vaccination as the path to elimination[J]. JAMA, 2023, 329( 19): 1639- 1640. DOI: 10.1001/jama.2023.2806.
    [20] CONNERS EE, PANAGIOTAKOPOULOS L, HOFMEISTER MG, et al. Screening and testing for hepatitis B virus infection: CDC recommendations-United States, 2023[J]. MMWR Recomm Rep, 2023, 72( 1): 1- 25. DOI: 10.15585/mmwr.rr7201a1.
    [21] SU TH, KAO JH. Improving clinical outcomes of chronic hepatitis B virus infection[J]. Expert Rev Gastroenterol Hepatol, 2015, 9( 2): 141- 154. DOI: 10.1586/17474124.2015.960398.
  • 加载中
图(5) / 表(3)
计量
  • 文章访问数:  309
  • HTML全文浏览量:  110
  • PDF下载量:  157
  • 被引次数: 0
出版历程
  • 收稿日期:  2024-04-06
  • 录用日期:  2024-04-09
  • 出版日期:  2024-05-25
  • 分享
  • 用微信扫码二维码

    分享至好友和朋友圈

目录

    /

    返回文章
    返回