RESUMEN
OVERVIEW: Over the past 15 years, the incidences of hepatitis A and B virus infection in the United States have declined significantly. By contrast, the incidence of hepatitis C virus infection, formerly stable or in decline, has increased by 75% since 2010. Suboptimal therapies of the past, insufficient provider awareness, and low screening rates have hampered efforts to improve diagnosis, management, and treatment of viral hepatitis. New screening recommendations, innovations in assessment and treatment, and an updated action plan from the U.S. Department of Health and Human Services (HHS) seem likely to lead to significant progress in the coming years. This article reviews the epidemiology, natural history, and diagnosis of viral hepatitis; discusses new screening recommendations, assessment tools, and treatments; and outlines the HHS action plan, focusing on the role of nurses in prevention and treatment.
Asunto(s)
Hepatitis Viral Humana/diagnóstico , Tamizaje Masivo/normas , Trastornos Relacionados con Sustancias/complicaciones , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/prevención & control , Antivirales/uso terapéutico , Progresión de la Enfermedad , Hepatitis A/epidemiología , Hepatitis A/prevención & control , Vacunas contra la Hepatitis A/administración & dosificación , Vacunas contra Hepatitis B/administración & dosificación , Hepatitis B Crónica/epidemiología , Hepatitis B Crónica/prevención & control , Hepatitis C Crónica/epidemiología , Hepatitis C Crónica/prevención & control , Hepatitis Viral Humana/tratamiento farmacológico , Hepatitis Viral Humana/epidemiología , Hepatitis Viral Humana/prevención & control , Humanos , Incidencia , Hepatopatías/diagnóstico , Hepatopatías/etiología , Rol de la Enfermera , Educación del Paciente como Asunto/normas , Guías de Práctica Clínica como Asunto , Pruebas Serológicas , Índice de Severidad de la Enfermedad , Trastornos Relacionados con Sustancias/prevención & control , Estados Unidos/epidemiología , United States Dept. of Health and Human Services/normasRESUMEN
There has been increasing attention in recent years to the HIV prevention, treatment, and care needs of key populations in Africa, in particular men who have sex with men (MSM), injection drug users (IDU), and female sex workers (FSW). While several major donors have undertaken efforts to prioritize these groups, it remains unclear which African countries are actively seeking donor support for these programs. For this analysis, we reviewed publicly available proposal and budget documentation from the US PEPFAR for fiscal years 2007 through 2010 and Rounds 1 through 10 of the Global Fund to Fight AIDS, Tuberculosis and Malaria for 40 countries in sub-Saharan Africa. Of the 164 searchable documents retrieved, nearly two-thirds contained at least one program serving FSW (65%, 107 proposals), less than one-third contained at least one program serving MSM (29%, 47 proposals), and a minority proposed programming for IDU (13%, 21 proposals). Demand for these programs was highly concentrated in a subset of countries. Epidemiological data for at least one key population was included in a majority of these proposals (63%, 67 proposals), but in many cases these data were not linked to programs.
