En estas directrices se actualiza la sección de recomendaciones sobre la prevención de la transmisión maternoinfantil de las Directrices para la prevención, la atención y el tratamiento de la infección crónica por el virus de la hepatitis B, publicadas por la OMS en el 2015, y se centra la at...ención en el uso de la profilaxis con antivirales en el embarazo. Su finalidad es proporcionar orientación respaldada por la evidencia acerca del uso de la profilaxis con antivirales durante el periparto en embarazadas que han dado positivo al HBsAg a efectos de prevenir la transmisión maternoinfantil del VHB. Los principales destinatarios son los funcionarios de los ministerios de salud que formulan las políticas nacionales y las directrices sobre la prevención de la transmisión maternoinfantil del VHB en todos los países, pero sobre todo en los de ingresos bajos y medianos. Asimismo, podrías ser útiles para los miembros del personal de salud que tratan a las personas con la infección por el VHB, así como a los que prestan atención a las embarazadas y los lactantes.
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Viral hepatitis is defined as inflammation of the liver cells due to viral infection. The burden of liver disease in South Africa is mostly underestimated as viral hepatitis, in particular chronic infection, is a silent and neglected cause of morbidity and mortality. However, the burden of disease i...s likely substantial given the prevalence of chronic viral hepatitis. This burden is further compounded by the lack of screening and access to care and treatment as well as inadequate disease surveillance, human and financial resources.
The National Guidelines for the Management of Viral Hepatitis were developed, with the purpose to:
inform healthcare workers in the public and private sectors about the disease, its epidemiology in South Africa and current methods of diagnosis and therapy
strengthen the healthcare response to viral hepatitis
empower communicable diseases workers and stakeholders to make informed decisions regarding appropriate and cost effective interventions
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ПЛАНИРОВАНИЕ И МОНИТОРИНГ ПРОГРЕССА НА ПУТИ К ЭЛИМИНАЦИИ
ПЛАНИРОВАНИЕ И МОНИТОРИНГ ПРОГРЕССА НА ПУТИ К ЭЛИМИНАЦИИ
The document describes the use of strategic information at various stages of the response in the context of strengthening broader health information systems. Strategic information can be defined as data collected at all service delivery and administrative levels to inform policy and programme decisi...ons.
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Guidelines for the care and treatment of persons diagnosed with chronic hepatitis C virus infection
В мае 2016 г. Всемирная ассамблея здравоохранения приняла первую Глобальную стратегию сектора здравоохранения (ГССЗ) по проблеме вирусных гепатитов. В ней б...ыла провозглашена цель к 2030 г. добиться элиминации вирусных гепатитов как угрозы общественному здоровью путем реализации (с достаточным уровнем охвата) пяти следующих основных вмешательств: иммунизация против гепатита B; профилактика передачи вируса гепатита B (ВГВ) от матери ребенку; обеспечение безопасности донорской крови и инъекций; принятие мер снижения вреда для людей, употребляющих инъекционные наркотики; предоставление услуг тестирования и лечения. Механизм ВОЗ по мониторингу и оценке в отношении вирусных гепатитов B и C соответствует подходу, ориентированному на результаты, который учитывает такие факторы, как контекст (распространенность инфекции), вкладываемые ресурсы, промежуточные и итоговые результаты (включая каскад мер профилактики, тестирования и лечения) и исходы (заболеваемость и смертность). Системы данных, необходимые для функционирования этого механизма, включают (i) эпиднадзор за ост-рыми гепатитами, случаями хронической инфекции и последствиями;* (ii) оперативные сведения, документирующие меры профилактики, тести-рования и лечения, которые включают каскад услуг медицинской помощи.
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Direct acting antivirals (DAAs) have revolutionized treatment for hepatitis C. Combi-
nations of DAAs can cure infection with HCV in 12 weeks, are highly effective and
have limited side-effects. Affordability of DAAs has improved significantly, but access remains lim-
i...ted. Initially, due to their high prices, affordability of DAAs was limited in high-, middle- and low-
income countries alike. Now there is a divide between those countries where, because of intellectual
property barriers, prices have remained (very) high and other countries where generics are, or can be,
available at much lower prices. The result is a dual market
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J Hepatol (2017), http://dx.doi.org/10.1016/j.jhep.2017.03.021
Testing and diagnosis of hepatitis B (HBV) and C (HCV) infection is the gateway for access to both prevention and treatment services, and is a crucial component of an effective response to the hepatitis epidemic. Early identification of persons with chronic HBV or HCV infection enables them to recei...ve the necessary care and treatment to prevent or delay progression of liver disease. Testing also provides an opportunity to link people to interventions to reduce transmission, through counselling on risk behaviours and provision of prevention commodities (such as sterile needles and syringes) and hepatitis B vaccination.
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With the goal of ending viral hepatitis as a public health threat by 2030, the Regional Action Plan will provide an actionable framework for implementing evidence-based interventions at scale. It will be informed through strategic monitoring of the response, that must be equitable and sustainable an...d allow for innovations for acceleration and reaching out to all in need with health services. A major reduction in prices of newer drugs to potentially cure hepatitis C offers an added opportunity to work towards its elimination.
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Le présent document énonce la première stratégie mondiale du secteur de la santé contre l’hépatite virale, une stratégie qui contribue à la réalisation du Programme de développement durable à l’horizon 2030.
Elle couvre les six premières années du plan d’action pour la santé... de l’après-2015, c’est-à-dire la période 2016-2021, en s’appuyant sur le document Prévention et lutte contre l’hépatite virale : cadre pour l’action mondiale et sur deux résolutions relatives à l’hépatite virale adoptées par l’Assemblée mondiale de la Santé en 2010 et en 2014.
Cette stratégie porte sur les cinq virus de l’hépatite (les hépatites A, B, C, D et E), en mettant plus spécialement l’accent sur les hépatites B et C en raison de la lourde charge relative qu’elles représentent pour la santé publique.
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The objectives of these WHO guidelines are to provide updated evidence- based recommendations for the treatment of persons with hepatitis C infection using, where possible, all DAA-only combinations. The guidelines also provide recommendations on the preferred regimens based on a patient’s HCV gen...otype and clinical history, and assess the appropriateness of continued use of certain medicines. This document also includes existing recommendations on screening for HCV infection and care of persons infected with HCV that were first issued in 2014
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Drugs, Diagnostics, Vaccines, Preventive Technologies, Research toward a cure, and immune-based and gene therapies in development
The recommendations in these guidelines promote the use of simple, non-invasive diagnostic tests to assess the stage of liver disease and eligibility for treatment; prioritize treatment for those with most advanced liver disease and at greatest risk of mortality; and recommend the preferred use of n...ucleos(t)ide analogues with a high barrier to drug resistance (tenofovir and entecavir, and entecavir in children aged 2–11 years) for first- and second-line treatment. Recommendations for the treatment of HBV/HIV-coinfected persons are based on the WHO 2013 Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection, which will be updated in 2015.
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Rapport technique
Le présent manuel vise à fournir des informations concernant les méthodes d’enquête sur les épidémies d’hépatite E, et les mesures de prévention et de contrôle appropriées. De plus, le manuel fournit des informations relatives à l’agent responsable – appelé... le Virus de l’hépatite E (VHE) – son épidémiologie, les manifestations cliniques de la maladie et le diagnostic.
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