C型肝炎病毒感染之流行病學及臨床處置

Epidemiology and Management of HCV Infection

楊宏志(Hung-Chih Yang)

《內科學誌》 31卷3期 (2020/06) Pp. 145-149

https://doi.org/10.6314/JIMT.202006_31(3).02

摘要

C型肝炎病毒感染是全球重要的公衛問題，全世界約有1億8千萬人受到C型肝炎病毒感染。根據2015年世界衛生組織（WHO）估計，慢性C型肝炎全球盛行率約是百分之一，約有患者7千1百萬人，其中大多數在亞洲。C型肝炎主要經由體液或血液傳染，目前仍無疫苗，但是透過公共衛生方法可以有效降低C型肝炎病毒之傳播。現今全口服抗病毒藥物的發明，已經徹底改變C型肝炎病毒的治療方式，過去標準治療使用長效型干擾素與口服雷巴威林，雖然效果不錯，但副作用大，病人接受度低。全口服抗病毒藥物效果極佳且安全性更高，病人接受度大，適合全面用於治療C型肝炎病患。2016年世界衛生大會宣示要在2030年前消除具公共衛生威脅性的病毒性肝炎，台灣則提出更具雄心的目標，要在2025年消滅C型肝炎。這將會是C型肝炎防治上的里程碑，使人類社會不再受到C型肝炎病毒的侵害。

關鍵字

C型肝炎病毒（Hepatitis C virus） ； 慢性C型肝炎（Chronic hepatitis C） ； 長效型干擾素（Pegylated interferon） ； 全口服抗病毒藥物（Direct antiviral agent）

並列摘要

Hepatitis C virus (HCV) infection is an important issue of global public health. Approximately 180 million individuals have been infected by HCV. Estimated by WHO in 2015, around 71 million patients were chronically infected by HCV, and most of them lived in Asia. The incidence of chronic hepatitis C (CHC) was about 1%. Hepatitis C is transmitted primarily via body fluid or blood. Development of all-oral direct antiviral agents (DAAs) has caused a paradigm shift for treatment of CHC. In the past, the standard care of CHC was the combination of pegylated interferon plus ribavirin, which had a higher risk of adverse effects and less tolerable, although it was quite effective. DAAs are more effective and safer, so are more welcome and suitable for treatment of CHC patients. In 2016, WHA advocated ＂to eliminate viral hepatitis as a public health threat by 2030＂. Taiwan's government has set a more ambitious goal, aiming to eliminate hepatitis C by 2025. This achievement will be a milestone for management and prevention of CHC, making human society free from the threat of HCV infection forever.