Ensuring pragmatic and equitable paths forward for hepatitis B virus infection elimination in Latin America.

IF 4.6 2区医学 Q1 INFECTIOUS DISEASES

Expert Review of Anti-infective Therapy Pub Date : 2026-08-26 DOI:10.1080/14787210.2026.2723574

Ezequiel Ridruejo, Javier Crespo, Hugo Cheinquer, Nelia Hernandez, Juan Turnes

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引用次数: 0

Abstract

Introduction: Latin America is a paradox in hepatitis B virus (HBV) elimination: aggregate prevalence is low, yet the region is far from WHO and PAHO 2030 targets because the burden is structurally concealed within underserved populations and fragmented health systems.

Areas covered: This review examines regional epidemiology, structural and programmatic barriers to elimination, and a pragmatic framework for populations of concentrated unmet need (indigenous communities, incarcerated and displaced persons, and people living with HIV), alongside perinatal prevention; hepatitis D, a defective satellite virus that requires hepatitis B surface antigen to replicate, endemic in the Amazon basin and the most rapidly progressive chronic viral hepatitis; simplified versus precise diagnosis in low-prevalence settings; and locally validated, equity-aware computational tools for case-finding, risk stratification, and investment prioritization. Evidence came from PubMed/MEDLINE (January 2010 to 30 April 2026) plus WHO, PAHO, and ALEH sources.

Expert opinion: Only 23% of people with chronic HBV in the WHO Region of the Americas are diagnosed and 4.5% treated. Closing that gap requires a shift from coverage-centered to precision-centered delivery: reaching the right individuals and coupling decentralization to active linkage to care. HBV elimination in Latin America is a systems delivery challenge under low apparent prevalence.

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确保在拉丁美洲为根除乙型肝炎病毒感染开辟务实和公平的前进道路。

拉丁美洲在消除乙型肝炎病毒（HBV）方面处于一个矛盾的位置：总流行率很低，但该地区仍远未达到世卫组织和泛美卫生组织2030年的目标，因为负担在结构上隐藏在服务不足的人群和分散的卫生系统中。覆盖区域:这一叙述性审查审查了区域流行病学状况、阻碍消除的结构性和方案障碍，以及侧重于未满足需求的集中人群（土著社区、被监禁者和流离失所者以及艾滋病毒感染者）的务实框架，以及围产期预防、丁型肝炎病毒合并感染、一种有缺陷的卫星病毒，需要乙型肝炎表面抗原完成其复制周期，并产生进展最迅速的慢性病毒性肝炎，在亚马逊流域流行，并在低患病率环境中简化和精确诊断之间取得平衡。我们还考虑了本地验证的、具有股票意识的计算工具如何支持病例发现、风险分层和投资优先级。通过2010年1月至2026年4月30日的PubMed/MEDLINE搜索确定了证据，并辅以世卫组织、泛美卫生组织和ALEH的规范和监测来源。专家意见：在世卫组织美洲区域，只有23%的慢性乙型肝炎病毒感染者得到诊断，4.5%得到治疗；要缩小这一差距，就需要从以覆盖为中心转向以精确为中心的交付，也就是说，接触到正确的个人，并将权力下放与积极的护理联系起来。在拉丁美洲，消除HBV最好被理解为在低表观患病率条件下的系统交付挑战。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Anti-infective Therapy 医学-药学

CiteScore

11.20

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Expert Review of Anti-Infective Therapy (ISSN 1478-7210) provides expert reviews on therapeutics and diagnostics in the treatment of infectious disease. Coverage includes antibiotics, drug resistance, drug therapy, infectious disease medicine, antibacterial, antimicrobial, antifungal and antiviral approaches, and diagnostic tests.