Ageing with a chronic hepatitis B (HBV) or hepatitis C (HCV) infection is an emerging public health priority. For people living with chronic viral hepatitis, their disease progression into old age is both underpinned by their existing blood borne virus and the potential emergence of other infectious and non-infectious conditions. These twinned pathways bring additional challenges to the care and support for people as they near end of life. This scoping review sought to examine what is known about the experiences of the end-of-life phase of an increasing population ageing with HBV and HCV in studies conducted in high-income settings and published in peer reviewed literature (2010–2021). In interpreting this literature, we found that challenges in determining the end-of life phase for people with lived experience of HBV or HCV are exacerbated by the conflation of aetiologies into a singular diagnosis of end-stage liver disease. Studies overwhelmingly reported the clinical aspects of end-of-life care (i.e. prognosis assessment and symptom management) with less attention paid to educative aspects (i.e. advance care directives and surrogate decision makers, discussion of treatment options and determining goals of care). Psychosocial interventions (i.e. quality of life beyond symptom management, including emotional/spiritual support and family and bereavement support) received limited attention in the literature, though there was some recognition that psychosocial interventions should be part of end-of-life care provision. Given the focus on the prominent disease presentation of liver cirrhosis and/or end-stage liver disease, the social and cultural dimensions of these infections have received less attention in the literature on end-of-life in the context of chronic viral hepatitis.

中文翻译：

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关于为临近生命终结时有慢性病毒性肝炎生活经历的老龄化人口提供的护理和支持的已知情况：范围界定审查

患有慢性乙型肝炎 (HBV) 或丙型肝炎 (HCV) 感染的老龄化是一项新兴的公共卫生重点。对于患有慢性病毒性肝炎的人来说，他们的疾病进展到老年既受到他们现有的血源性病毒的支持，也受到其他传染性和非传染性疾病的潜在出现的支持。这些相互关联的途径给临近生命终点的人们的护理和支持带来了额外的挑战。本范围界定审查旨在检验在高收入环境中进行并发表于同行评审文献（2010-2021 年）的研究中，关于 HBV 和 HCV 人口老龄化加剧的临终阶段经历的已知信息。在解读这些文献时，我们发现，将病因学合并为终末期肝病的单一诊断，加剧了确定具有 HBV 或 HCV 生活经历的人的生命终结阶段的挑战。绝大多数研究报告了临终关怀的临床方面（即预后评估和症状管理），而较少关注教育方面（即预先护理指令和代理决策者、治疗方案的讨论和确定护理目标）。社会心理干预（即症状管理之外的生活质量，包括情感/精神支持以及家庭和丧亲支持）在文献​​中受到的关注有限，尽管人们认识到社会心理干预应该成为临终关怀提供的一部分。