Younossi Z M, Kanwal F, Saab S, Brown K A, El-Serag H B, Kim W R, Ahmed A, Kugelmas M, Gordon S C
Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA; Department of Medicine, Center for Liver Disease, Inova Fairfax Hospital, Falls Church, VA, USA.
Aliment Pharmacol Ther. 2014 Mar;39(5):518-31. doi: 10.1111/apt.12625. Epub 2014 Jan 26.
Infection with the hepatitis C virus (HCV) has been considered a major cause of mortality, morbidity and resource utilisation in the US. In addition, HCV is the main cause of hepatocellular cancer (HCC) in the US. Recent developments in the diagnosis and treatment of HCV, including new recommendations pertaining to screening for HCV by the Centers for Disease Control and Prevention and newer treatment regimens with high efficacy, short duration and the potential for interferon-free therapies, have energised the health care practitioners regarding HCV management.
To assess the full impact of HCV burden on clinical, economic and patient-reported outcomes.
An expert panel was convened to assess the full impact of HCV burden on a number of important outcomes using an evidence-based approach predicated on Grading of Recommendations Assessment, Development and Evaluation methodology. The literature was summarised, graded using an evidence-based approach and presented during the workshop. Workshop presentations were intended to review recent, relevant evidence-based literature and provide graded summary statements pertaining to HCV burden on topics including the relationships between HCV and the development of important outcomes.
The associations of HCV with cirrhosis, HCC, liver-related mortality, type 2 diabetes mellitus, rheumatological diseases and quality of life impairments are supported by strong evidence. Also, there is strong evidence that sustained viral eradication of HCV can improve important outcomes such as mortality and quality of life.
The current evidence suggests that HCV has been associated with tremendous clinical, economic and quality of life burden.
丙型肝炎病毒(HCV)感染一直被认为是美国死亡率、发病率和资源利用的主要原因。此外,HCV是美国肝细胞癌(HCC)的主要病因。HCV诊断和治疗方面的最新进展,包括疾病控制与预防中心关于HCV筛查的新建议以及疗效高、疗程短且有潜力实现无干扰素治疗的新型治疗方案,让医护人员对HCV管理充满活力。
评估HCV负担对临床、经济和患者报告结局的全面影响。
召集了一个专家小组,采用基于推荐分级评估、制定与评价方法的循证方法,评估HCV负担对一系列重要结局的全面影响。对文献进行了总结,采用循证方法分级,并在研讨会上展示。研讨会报告旨在回顾近期相关的循证文献,并提供关于HCV负担在包括HCV与重要结局发生之间关系等主题上的分级总结陈述。
有充分证据支持HCV与肝硬化、HCC、肝脏相关死亡率、2型糖尿病、风湿性疾病及生活质量受损之间的关联。此外,有充分证据表明持续根除HCV病毒可改善死亡率和生活质量等重要结局。
目前的证据表明,HCV与巨大的临床、经济和生活质量负担相关。