In 2016, the World Health Organization developed a plan for viral hepatitis elimination by 2030. Globally, control of hepatitis B virus (HBV) and hepatitis C virus (HCV) are the most challenging aspects of viral hepatitis elimination. In many developed countries elimination of HBV could be targeted to special populations mostly immigrants from low resource settings. Elimination of HCV, however, remains a challenge globally. Barriers to HCV elimination include high cost of medications and the ability to engage specific at-risk populations as well as individuals who are out of medical care. In the context of the coronavirus disease 2019 (COVID-19) pandemic, treatment access and screening have been further negatively impacted by social distancing rules and COVID-19-related anxieties. This threatens to throw most countries off course in their elimination efforts. Before the pandemic, some states in the United States had scaled up their elimination efforts with plans to ramp up testing and treatment using Netflix-like payment models for HCV direct acting antiviral drugs. Most of these efforts have stalled on account of the health system's focus on COVID-19 control. To prevent further delays in achieving elimination targets, programs would need to explore new models of care that address COVID-19-related access hurdles. Systems that leverage technologies such as telemedicine and self-testing could help maintain treatment levels. Mathematical models estimate that COVID-19-related delays in 2020 could lead to 44,800 hepatocellular cancers and 72,300 liver-related deaths for the next decade.

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2019 年冠状病毒病大流行对消除病毒性肝炎的影响：价格是多少？

2016年，世界卫生组织制定了到2030年消除病毒性肝炎的计划。在全球范围内，控制乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）是消除病毒性肝炎最具挑战性的方面。在许多发达国家，消除 HBV 的目标是特殊人群，主要是来自资源匮乏地区的移民。然而，消除 HCV 仍然是全球性的挑战。消除 HCV 的障碍包括高昂的药物成本和参与特定高危人群以及无法获得医疗保健的个人的能力。在 2019 年冠状病毒病 (COVID-19) 大流行的背景下，社交距离规则和与 COVID-19 相关的焦虑进一步对治疗和筛查产生了负面影响。这有可能使大多数国家的消除努力偏离正轨。在大流行之前，美国的一些州已经加大了消除力度，计划使用类似 Netflix 的支付模式来增加检测和治疗 HCV 直接作用抗病毒药物的力度。由于卫生系统对 COVID-19 控制的关注，这些努力中的大多数都停滞不前。为了防止进一步延迟实现消除目标，项目需要探索新的护理模式，以解决与 COVID-19 相关的获取障碍。利用远程医疗和自我测试等技术的系统可以帮助维持治疗水平。数学模型估计，2020 年与 COVID-19 相关的延误可能导致未来十年 44,800 例肝细胞癌和 72,300 例肝脏相关死亡。美国的一些州已经加大了消除力度，计划使用类似 Netflix 的支付模式来增加检测和治疗 HCV 直接作用抗病毒药物的力度。由于卫生系统对 COVID-19 控制的关注，这些努力中的大多数都停滞不前。为了防止进一步延迟实现消除目标，项目需要探索新的护理模式，以解决与 COVID-19 相关的获取障碍。利用远程医疗和自我测试等技术的系统可以帮助维持治疗水平。数学模型估计，2020 年与 COVID-19 相关的延误可能导致未来十年 44,800 例肝细胞癌和 72,300 例肝脏相关死亡。美国的一些州已经加大了消除力度，计划使用类似 Netflix 的支付模式来增加检测和治疗 HCV 直接作用抗病毒药物的力度。由于卫生系统对 COVID-19 控制的关注，这些努力中的大多数都停滞不前。为了防止进一步延迟实现消除目标，项目需要探索新的护理模式，以解决与 COVID-19 相关的获取障碍。利用远程医疗和自我测试等技术的系统可以帮助维持治疗水平。数学模型估计，2020 年与 COVID-19 相关的延误可能导致未来十年 44,800 例肝细胞癌和 72,300 例肝脏相关死亡。