丙型肝炎 z-bo 2020-09-17 356

　　It has been 25 years since the discovery of hepatitis C. From the initial understanding of non-A and non-B hepatitis viruses, to the eradication of hepatitis C after achieving a cure rate of over 90%, what is the course of these 25 years and what are the milestones? Is the event worth remembering?

　　1989: Hepatitis C virus was discovered

　　Before the discovery of hepatitis C virus (HCV) by scientists from the Centers for Disease Control and Prevention, the National Institutes of Health and related industries, people's understanding of the hepatitis C virus has been stuck on non-A and non-B hepatitis viruses.

　　In 1989, Choo and his colleagues first isolated hepatitis C virus from the serum of a patient with non-A and non-B hepatitis. It was gradually discovered that almost all non-A and non-B hepatitis in the United States were caused by the hepatitis C virus.

　　The discovery of hepatitis C virus has also promoted the research of candidate vaccine virus targets and therapeutic drugs. The genetic diversity of the hepatitis C virus and the relatively weak immune response to its infection have brought great difficulties to the development of vaccines.

　　1991: First treatment for hepatitis C

　　The U.S. Food and Drug Administration (FDA) first approved the drug treatment of hepatitis C-interferon alpha-2b in 1991. However, the sustained virological response rate of the treated patients was very low, and the cure rate was only 6%.

　　Since 1991, the effective rate of hepatitis C treatment has been continuously improved, and recent treatment programs can even clear up to 90% of patients.

　　1992: The United States ensures the safety of blood supply

　　Since 1990, the United States has routinely screened blood for HCV. After 1992, a more sensitive multi-antigen test was adopted, which further reduced the risk of infection and essentially eliminated hepatitis C transmitted by blood transfusion. At the same time, the CDC recommends that people who received blood transfusions or organ transplants be screened for HCV before July 1992.

　　1996: The number of hepatitis C infection cases dropped significantly

　　In 1996, the number of new cases of HCV infection reported throughout the year dropped by more than 80%. This was largely due to the routine screening of blood products in the United States and new protection and infection control measures to control the spread of hepatitis C.

　　1998: US CDC released hepatitis C screening recommendations

　　美 CDC issued the first hepatitis C prevention and control recommendations, including screening high-risk groups. These recommendations are in addition to the previously recommended screening and follow-up of blood, plasma, organ, tissue and sperm donors.

　　2007: The number of hepatitis C deaths in the United States exceeds HIV

　　Although the number of new HCV infections has dropped significantly, the number of deaths caused by HCV has risen from 3 per 100,000 (10,000 people) in 1999 to 5 per 10 (10,000 people) in 2007. The fatality rate of HIV has dropped from 6 per 100,000 (10,000 people) in 1999 to 4 per 100,000 (10,000 people) in 2007. It is especially worth noting that HCV is 10 times more infectious than HIV.

　　2010: Rapid testing comes out

　　The FDA approved the first HCV rapid blood test for high-risk patients 15 years and older. The test can get results in only 20 minutes.

　　2011: The first World Hepatitis Day; new drug development

　　Against the background that the global burden of hepatitis C is increasing and affecting the lives and health of 150-170 million people, the World Health Organization and US President Obama officially declared July 28 as World Hepatitis Day.

　　Also in this year, the first generation of antiviral drugs, protease inhibitors, emerged. These drugs can directly act on the non-structural proteins of HCV and interfere with the replication and assembly of the virus in the host liver cells. When combined with peginterferon and ribavirin for 24-48 weeks, the cure rate of genotype 1 HCV patients can be increased to 70%.

　　2012: CDC recommends screening for hepatitis C for "baby boomers"

　　Data shows that the population born between 1945 and 1965 accounted for 75% of all HCV-infected persons in the United States and 73% of HCV-related deaths. Therefore, the CDC included a one-time test on the "baby boomer" birth population into its recommended test range. If implemented in full, this CDC recommendation will find about 1 million people with HCV infection who need treatment.

　　2013: The prospects for treatment are bright

　　In 2013, the FDA approved new antiviral drugs. When treated with a full oral medication regimen, or combined with peginterferon and ribavirin, it is expected that 90% of patients will be cured after 12-24 weeks of treatment with few serious side effects.

　　2014: 25 years since hepatitis C was discovered

　　In the past 25 years, humans’ scientific understanding of the hepatitis C virus has continued to deepen. Because of this, the United States and the world have a collective response to this serious disease, including the development of hepatitis C management based on evidence-based medicine recommendations. With the emergence of the latest and efficient treatment of HCV, it is expected that the pace of positive change is coming.

　　Outlook: Eliminating HCV may be possible

　　In recent years, new progress has been made in the treatment of HCV, from the first approval of the treatment of HCV to the introduction of high-efficiency protease inhibitors in 2011, followed by the approval of new antiviral drugs in 2013, and the pace of change is expected to accelerate: a large number of different mechanisms of action New drugs are expected to come out in the next few years. Thus, for the first time, it is possible to eliminate hepatitis C.