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JGH:根除丙型肝炎病毒可降低肝硬化和肝硬化相关并发症的风险

2021-10-13 MedSci原创 MedSci原创

丙肝是由于丙型肝炎病毒引起的。人们习惯用“沉默的杀手”来形容,可见丙肝对人体的危害有多大。丙肝转肝硬化的几率有多大?

      丙肝是由于丙型肝炎病毒引起的。人们习惯用“沉默的杀手”来形容,可见丙肝对人体的危害有多大。丙肝转肝硬化的几率有多大?丙肝的病理改变和乙肝极为相似,丙肝是以肝细胞坏死和淋巴细胞浸润为主。慢性丙肝可出现汇管区纤维组织增生,严重者可以形成假小叶即成为肝硬化。但是,由于丙肝早期症状不十分明显,很多人在被感染了丙肝病毒,却根本就不知情。目前尚不清楚使用聚乙二醇干扰素和利巴韦林 (PR) 疗法根除丙型肝炎病毒 (HCV) 对非肝硬化患者新发肝硬化 (LC) 的发生率以及失代偿性肝病 (DLD) 或肝细胞癌(HCC)的发生率有何影响。

 

      研究人员收集了2003年至2015年间台湾23家医院间所有的HCV病例,共10693名慢性丙型肝炎 (CHC) 患者本纳入本项研究,其中所有患者均接受了PR治疗至少 4 周以治疗新发 LC 和肝脏相关并发症(DLD 或 HCC)。

 

      在10693名患者中,有1372 名 (12.8%) 患者患有LC,平均年龄为 54.0±11.4岁。平均随访时间为4.38±2.79 年,总计 46798 人年。在具有持续病毒学应答 (SVR) 的无肝硬化患者中,新发LC的10年累积发生率为5.0%(95% 置信区间 [CI]:3.2-7.7),而在在没有SVR的患者中新发LC的10年累积发生率为21.9%(95% CI:13.4- 32.4)(风险比 [HR]:0.22,P < 0.001)。在调整年龄后,有 SVR 的肝硬化患者肝脏相关并发症的 10 年累积发生率为 21.4%(95% CI:11.1-37.2),无 SVR 患者为 47.0%(95% CI:11.1-86.0)。

 

       因此,用 PR 治疗根除丙型肝炎病毒可降低非肝硬化患者新发 LC 的发生率和肝硬化 CHC 患者肝脏相关并发症的发生率。

 

 

原始出处:

Wei-Fan Hsu. Et al. Hepatitis C virus eradication decreases the risks of liver cirrhosis and cirrhosis-related complications (Taiwanese chronic hepatitis C cohort). Journal of Gastroenterology and Hepatology.2021.

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    2022-02-04 丁鹏鹏
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    2021-11-05 风铃830
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    2021-10-14 ms2000000182667314

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