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抗病毒治疗对HIV与丙型肝炎病毒合并感染患者肝纤维化血清标志物的影响:Fibrovic 2研究-法国国家艾滋病研究机构HC02项目

Effect of antiviral treatment on serum markers of liver fibrosis in HIV-hepatitis C virus-coinfected patients: the Fibrovic 2 Study - ANRS HC02.

作者信息

Halfon Philippe, Carrat Fabrice, Bédossa Pierre, Lambert Jérôme, Pénaranda Guillaume, Perronne Christian, Pol Stanislas, Cacoub Patrice

机构信息

Laboratoire Alphabio, Service de Maladies Infectieuses, Hôpital Ambroise Paré, Marseille, France.

出版信息

Antivir Ther. 2009;14(2):211-9.

Abstract

BACKGROUND

Non-invasive liver fibrosis scores have been proposed as alternatives to liver biopsy (LB) in hepatitis C virus (HCV)-infected patients. Here, we aimed to assess the effect of antiviral treatment on non-invasive serological markers of liver fibrosis in HIV-HCV-coinfected patients.

METHODS

We included 114 HIV-HCV-coinfected patients with LBs performed before and 6 months after the end of treatment (week 72; W72). Fibrotest, the Forn's index, age-platelet ratio index, SHASTA, FIB-4, Hepa-score and Fibrometer scores were assessed. There were 29 (25%) patients who achieved sustained virological response (SVR).

RESULTS

At baseline (BL), all non-invasive fibrosis scores except the Forn's index did not show significantly lower values in SVR patients. At W72, all non-invasive scores, except Hepascore, showed a significant decrease in SVR patients (P<0.01). There was a significant difference in fibrosis stages on LBs between BL and W72 in SVR and non-SVR patients.

CONCLUSIONS

In HIV-HCV-coinfected patients, HCV clearance is associated with a significant reduction in non-invasive fibrosis serological markers, which most likely reflect the histological improvement associated with SVR. If confirmed, such results will reinforce the reliability of these markers in the follow-up after HCV treatment.

摘要

背景

在丙型肝炎病毒(HCV)感染患者中,已提出无创肝纤维化评分可作为肝活检(LB)的替代方法。在此,我们旨在评估抗病毒治疗对HIV-HCV合并感染患者肝纤维化无创血清学标志物的影响。

方法

我们纳入了114例HIV-HCV合并感染患者,在治疗结束前(第72周;W72)和结束后6个月进行了肝活检。评估了Fibrotest、Forn指数、年龄-血小板比率指数、SHASTA、FIB-4、Hepa评分和Fibrometer评分。有29例(25%)患者实现了持续病毒学应答(SVR)。

结果

在基线(BL)时,除Forn指数外,所有无创纤维化评分在SVR患者中均未显示出显著更低的值。在W72时,除Hepa评分外,所有无创评分在SVR患者中均显著降低(P<0.01)。SVR和非SVR患者在BL和W72时肝活检的纤维化分期存在显著差异。

结论

在HIV-HCV合并感染患者中,HCV清除与无创纤维化血清学标志物的显著降低相关,这很可能反映了与SVR相关的组织学改善。如果得到证实,这些结果将加强这些标志物在HCV治疗后随访中的可靠性。

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