中国建国以来防控病毒性肝炎工作进展

Progress in prevention and control of viral hepatitis since the establishing of the People's Republic of China

我国是病毒性肝炎疾病负担最重的国家。在摸清我国病毒性肝炎流行特征,提出科学防控策略后,我国政府有力践行了“预防为主、防治结合”的政策。尤其是近40多年来的努力,我国在推行预防接种、加强血液筛查、规范诊疗服务、加强监管方面都采取了有力措施,并取得显著成效。甲型肝炎发病率从1990年的52.6/10万降至2019年的1.38/10万,5岁以下儿童乙型肝炎病毒表面抗原携带率从1992年的9.67%下降到2014年的0.32%,慢性丙型肝炎感染者治愈率已经实现95%以上,戊型肝炎的发病率也呈下降趋势。但是,估计2019年乙型肝炎患者的诊断率为25%,治疗率为17%;估计丙型肝炎诊断率为30%,治疗率为9%。这与达到2030年90%诊断率和80%治疗率的目标还有很大差距。建议国家尽早出台相关政策,开展健康促进,加强筛查和诊疗服务,以促进更多的慢性乙型肝炎患者得到及时的治疗。

China has the highest disease burden of viral hepatitis.After understanding the epidemic characteristics of viral hepatitis in China and putting forward scientific prevention and control strategies,the Chinese government has been effectively practicing the policy of"prevention first with combination of prevention and control".Over the past 40 years,China has taken effective measures to promote vaccination,strengthen blood screening,standardize diagnosis and treatment services and strengthen supervision,and achieved remarkable success.The incidence of hepatitis A decreased from 52.6 per 100,000in 1990 to 1.38 per 100,000 in 2019,the HBsAg prevalence among children under 5 years of age decreased from 9.67%in 1992 to 0.32%in 2014,and the cure rate of chronic hepatitis C patients has reached more than 95%.The incidence of hepatitis E is also on the decline.However,in 2019,the estimated diagnosis rate for hepatitis B patients is 25%and treatment rate is 17%;hepatitis C diagnosed rate is 30%and only 9%of the diagnosed were treated.This still falls far from the target of 90%diagnosis rate and 80%treatment rate by 2030.Relevant policies should be implemented as soon as possible,health promotion should be carried out,and screening and diagnosis and treatment services should be strengthened to promote timely treatment for more chronically infected people.