Introduction:Current strategies for chronic viral hepatitis prevention and control include immunization,prevention of mother-to-child transmission,expanded testing,antiviral therapy,and national drug price negotiation...Introduction:Current strategies for chronic viral hepatitis prevention and control include immunization,prevention of mother-to-child transmission,expanded testing,antiviral therapy,and national drug price negotiations.To achieve this effectively,Shanghai has implemented a communitybased pilot program that integrates public health and clinical care for chronic viral hepatitis management.Methods:This study evaluated the effectiveness of Shanghai’s community-based healthcare program at three time points(2012,2019,and 2023),assessing key indicators including antiviral treatment rates and disease status changes and risk of hepatocellular carcinoma.Data were managed using EpiData 3.1,with descriptive statistics and chi-square tests performed using SPSS 29.0.Results:The study enrolled 1,478,1,901,and 7,714 patients in 2012,2019,and 2023,respectively.During the management period,the number of enrolled patients increased substantially from baseline.The antiviral treatment rates in 2019 and 2023 reached 64.5%and 58.2%,with both significantly higher than the baseline rate of 24.5%in 2012.Concurrently,abnormality rates for hepatitis B virus deoxyribonucleic acid(HBV DNA),alanine aminotransferase(ALT),total bilirubin(TBIL),and fibrosis indices decreased significantly in 2019 and 2023.The 2023 aMAP score further revealed a decline in hepatocellular carcinoma risk among managed patients(32.2%vs.26.3%).With enhanced community healthcare capacity,14.1%(2019)and 18.2%(2023)of patients accessed community dispensing services,aligning with the strategy to decentralize testing and treatment for disease elimination.Conclusions:Community-based healthcare management for chronic hepatitis in Shanghai provides patients with decentralized hepatitis-related testing and treatment services,creating an effective environment for chronic viral hepatitis prevention and control and would favorable for the viral hepatitis elimination efforts.展开更多
基金Supported by the Shanghai Three-year Action Plan to Strengthen the Public Health System(Grant No.GWVI-9)the Shanghai Municipal Health Commission Youth Project(Grant No.20224Y0333).
文摘Introduction:Current strategies for chronic viral hepatitis prevention and control include immunization,prevention of mother-to-child transmission,expanded testing,antiviral therapy,and national drug price negotiations.To achieve this effectively,Shanghai has implemented a communitybased pilot program that integrates public health and clinical care for chronic viral hepatitis management.Methods:This study evaluated the effectiveness of Shanghai’s community-based healthcare program at three time points(2012,2019,and 2023),assessing key indicators including antiviral treatment rates and disease status changes and risk of hepatocellular carcinoma.Data were managed using EpiData 3.1,with descriptive statistics and chi-square tests performed using SPSS 29.0.Results:The study enrolled 1,478,1,901,and 7,714 patients in 2012,2019,and 2023,respectively.During the management period,the number of enrolled patients increased substantially from baseline.The antiviral treatment rates in 2019 and 2023 reached 64.5%and 58.2%,with both significantly higher than the baseline rate of 24.5%in 2012.Concurrently,abnormality rates for hepatitis B virus deoxyribonucleic acid(HBV DNA),alanine aminotransferase(ALT),total bilirubin(TBIL),and fibrosis indices decreased significantly in 2019 and 2023.The 2023 aMAP score further revealed a decline in hepatocellular carcinoma risk among managed patients(32.2%vs.26.3%).With enhanced community healthcare capacity,14.1%(2019)and 18.2%(2023)of patients accessed community dispensing services,aligning with the strategy to decentralize testing and treatment for disease elimination.Conclusions:Community-based healthcare management for chronic hepatitis in Shanghai provides patients with decentralized hepatitis-related testing and treatment services,creating an effective environment for chronic viral hepatitis prevention and control and would favorable for the viral hepatitis elimination efforts.
