Ambulatório Municipal de Hepatites Virais Ouro Verde, Campinas, SP, Brazil.
Eur J Gastroenterol Hepatol. 2014 Mar;26(3):313-8. doi: 10.1097/MEG.0b013e328362dbff.
Although hepatitis B virus (HBV) and hepatitis C virus (HCV) are both hepatotropic and quite similar in terms of clinical manifestations and histopathology, their respective infections are distinct in terms of epidemiology and prognosis. Recognizing the differences between patients with HBV and HCV infection with respect to demographic characteristics, prevalence of comorbidities, and presence of lifestyle factors aids the proper treatment of these patients. We aimed to compare two populations with chronic viral liver disease (chronic HCV and chronic HBV), each of them with resolved hepatitis C.
We included patients referred to a municipal reference clinic from March 2009 through May 2012. Patient data were collected using standardized questionnaires at the patients' first visit to clinic. Questionnaires included epidemiological information, presence of comorbidities, and lifestyle.
A total of 756 patients were included in the study, 348 (46.0%) with chronic HCV infection, 176 (23.3%) with chronic HBV infection, and 232 (30.7%) with resolved HCV infection. Multivariate analysis including patients with chronic HCV infection and chronic HBV infection indicated that age [adjusted odds ratio (AOR)=1.06; 95% confidence interval (CI): 1.03-1.08], alcohol abuse (AOR=1.58; 95% CI: 1.01-2.49), smoking (AOR=1.64; 95% CI: 1.00-2.17), and illicit drug (AOR=2.92; 95% CI: 1.69-5.02) use were associated independently with chronic HCV infection. Multivariate analyses including patients with chronic HCV infection and those patients with resolved HCV infection, presence of at least one comorbidity (AOR=1.94; 95% CI: 1.12-3.3), illicit drug use (AOR=3.24; 95% CI: 1.90-5.54), and age (AOR=1.03; 95% CI: 1.01-1.05) were independently associated with chronic HCV infection. Age (AOR=0.98; 95% CI: 0.96-0.99) and male sex (AOR=1.93; 95% CI: 1.26-2.95) were the only variables associated significantly with chronic HBV infection in the multivariate analysis between patients with chronic HBV infection and resolved HCV infection.
Our results highlight that patients with chronic HCV infection are complex and require a multidisciplinary approach during patient follow-up and clinical management.
尽管乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）均为嗜肝病毒，且在临床表现和组织病理学方面非常相似，但它们在流行病学和预后方面的各自感染情况却截然不同。认识到 HBV 和 HCV 感染患者在人口统计学特征、合并症患病率和生活方式因素方面的差异有助于对这些患者进行适当的治疗。我们旨在比较两种慢性病毒性肝病（慢性 HCV 和慢性 HBV）人群，每个人群都有已解决的丙型肝炎。
我们纳入了 2009 年 3 月至 2012 年 5 月间被转诊到市参考诊所的患者。患者的基本资料通过患者首次就诊时的标准化问卷收集。问卷包括流行病学信息、合并症存在情况和生活方式。
共纳入 756 例患者，其中 348 例（46.0%）患有慢性 HCV 感染，176 例（23.3%）患有慢性 HBV 感染，232 例（30.7%）患有已解决的 HCV 感染。包括慢性 HCV 感染和慢性 HBV 感染患者的多变量分析表明，年龄[调整后的优势比（AOR）=1.06；95%置信区间（CI）：1.03-1.08]、酒精滥用（AOR=1.58；95%CI：1.01-2.49）、吸烟（AOR=1.64；95%CI：1.00-2.17）和非法药物（AOR=2.92；95%CI：1.69-5.02）的使用与慢性 HCV 感染独立相关。包括慢性 HCV 感染患者和已解决 HCV 感染患者的多变量分析表明，至少存在一种合并症（AOR=1.94；95%CI：1.12-3.3）、非法药物使用（AOR=3.24；95%CI：1.90-5.54）和年龄（AOR=1.03；95%CI：1.01-1.05）与慢性 HCV 感染独立相关。年龄（AOR=0.98；95%CI：0.96-0.99）和男性（AOR=1.93；95%CI：1.26-2.95）是慢性 HBV 感染患者与已解决 HCV 感染患者的多变量分析中唯一与慢性 HBV 感染显著相关的变量。
我们的结果强调，慢性 HCV 感染患者情况复杂，在患者随访和临床管理过程中需要多学科方法。
