Territory-wide population-based study of chronic hepatitis C infection and implications for hepatitis elimination in Hong Kong.

Autor: Hui YT; Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China., Wong GLH; Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China., Fung JYY; Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China., Chan HLY; Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China., Leung NWY; Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China., Liu SD; Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China., Liu K; Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China., Ma YK; Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong, China., But DYK; Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China., Mak WY; Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China., Chan JMC; Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China., Lai KB; Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong, China., Loo CK; Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong, China., Ng ACY; Department of Medicine and Geriatrics, Caritas Medical Centre, Hong Kong, China., Lai MS; Department of Medicine, North District Hospital, Hong Kong, China., Chan CW; Department of Medicine, Yan Chai Hospital, Hong Kong, China., Lau JYL; Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China., Fan TTT; Department of Medicine, Tseung Kwan O Hospital, Hong Kong, China., Hui AJ; Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China., Lam BCY; Department of Medicine and Geriatrics, Pok Oi Hospital, Hong Kong, China., Cheung WI; Department of Medicine, Our Lady of Maryknoll Hospital, Hong Kong, China., Tsang OTY; Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China., Lam K; Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China., Lai LSW; Department of Medicine and Geriatrics, Pok Oi Hospital, Hong Kong, China., Luk WF; Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China., Li MKK; Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong, China., Lao WC; Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China., Lam JTW; Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China., Tsang SWC; Department of Medicine, Tseung Kwan O Hospital, Hong Kong, China., Kung KN; Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong, China., Chow WH; Department of Medicine, Yan Chai Hospital, Hong Kong, China., Tong RKN; Department of Medicine and Geriatrics, Caritas Medical Centre, Hong Kong, China., Lui TKL; Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China., Shan EHS; Department of Medicine and Geriatrics, Caritas Medical Centre, Hong Kong, China., Yuen MF; Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China., Wong VWS; Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
Jazyk: angličtina
Zdroj: Liver international : official journal of the International Association for the Study of the Liver [Liver Int] 2018 Nov; Vol. 38 (11), pp. 1911-1919. Date of Electronic Publication: 2018 Jul 30.
DOI: 10.1111/liv.13926
Abstrakt: Background: To study the epidemiology of chronic hepatitis C virus infection in Hong Kong and to estimate the service gap for achieving the WHO hepatitis elimination targets of attaining a diagnosis rate of 90%, treatment rate of 80% and 65% reduction in mortality rate by 2030.
Methods: From January 2005 to March 2017, patients who were tested positive for anti-HCV were retrospectively retrieved from all public hospitals in Hong Kong. The epidemiological data of 15 participating hospitals were analysed.
Results: A total of 11 309 anti-HCV+ patients were identified and the estimated diagnosis rate was 50.9%. Our HCV-infected patients were ageing (median age 59). The all-cause mortality rate increased from 26.2 to 54.8 per 1000 person-years over the last decade. Our estimated treatment rate was 12.4%. Among the treated patients, 93.6% had received pegylated interferon/ribavirin (Peg-IFN/RBV) but only 10.8% had received interferon-free direct-acting antivirals (DAAs). In a cohort of 1533 patients, 39% already had advanced liver fibrosis or cirrhosis. The sustained virological response rate for Peg-IFN/RBV and DAAs were 74.8% and 97.2% respectively. However, more than 70% of patients were not subjected to interferon treatment for various reasons. Patients who achieved SVR were associated with a significantly lower risk of HCC (4.7% vs 9.6%, P = 0.005) and death (1.7% vs 23.8%, P < 0.001).
Conclusion: Our diagnosis rate, treatment rate and mortality rate reduction were still low, particularly the Peg-IFN outcomes, making it difficult to meet the WHO hepatitis elimination targets. A more generalized use of DAAs is urgently needed to improve the situation.
(© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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