Division of Gastroenterology & Hepatology, Tri-Service General Hospital, National Defense Medical Center, Taiwan.
Ann Hepatol. 2013 Jan-Feb;12(1):78-84.
The aim of this study is to evaluate the role of hepatitis C virus (HCV) infection in patients with primary biliary cirrhosis (PBC).
On the basis of a retrospective review of medical records, all patients consecutively diagnosed with PBC or HCV infection between 1999 and 2011 and who had a regular follow-up of at least 3 years were included in the study. Clinical characteristics, especially the severity of cirrhosis, were analyzed in PBC patients with HCV infection (PBC-HCV), PBC patients without HCV infection (PBC-only), and patients with only HCV infection (HCV-only).
A total of 76 patients with PBC, including 9 patients with HCV infection, were analyzed. Of the PBC-HCV patients, 7 (7/9, 77.8%) were women with a mean age of 55.11 ± 14.29 years. Age- and sex-matched PBC-only patients (n = 36) and HCV-only patients (n = 36) were used as control groups. In comparison to the PBC-only controls, PBC-HCV patients had a greater severity of cirrhosis based on Child-Pugh (p = 0.019) and Model for End-Stage Liver Disease (MELD) (p = 0.01) scores. However, no significant difference in the severity of cirrhosis was found between the PBC-HCV and HCV-only control patients (p = 0.94 in Child-Pugh scores; p = 0.64 in MELD scores).
In PBC patients with concomitant HCV infection, aggressive management may be warranted in view of the associated more severe liver cirrhosis.
本研究旨在评估丙型肝炎病毒（HCV）感染在原发性胆汁性肝硬化（PBC）患者中的作用。
基于对病历的回顾性分析，本研究纳入了 1999 年至 2011 年间连续诊断为 PBC 或 HCV 感染且随访时间至少 3 年的患者。分析了 HCV 感染的 PBC 患者（PBC-HCV）、无 HCV 感染的 PBC 患者（PBC-only）和单纯 HCV 感染患者（HCV-only）的临床特征，尤其是肝硬化的严重程度。
共分析了 76 例 PBC 患者，其中 9 例合并 HCV 感染。9 例 PBC-HCV 患者中，7 例（7/9，77.8%）为女性，平均年龄为 55.11±14.29 岁。将年龄和性别匹配的 PBC-only 患者（n=36）和 HCV-only 患者（n=36）作为对照组。与 PBC-only 对照组相比，PBC-HCV 患者的肝硬化严重程度根据 Child-Pugh（p=0.019）和终末期肝病模型（MELD）评分更高（p=0.01）。然而，PBC-HCV 患者与 HCV-only 对照组患者的肝硬化严重程度无显著差异（Child-Pugh 评分：p=0.94；MELD 评分：p=0.64）。
鉴于合并 HCV 感染的 PBC 患者可能存在更严重的肝硬化，需要积极治疗。
