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接受抗丙型肝炎病毒治疗的丙型肝炎患者患白内障风险增加:一项全国性队列研究。

Increasing risk of cataract in HCV patients receiving anti-HCV therapy: A nationwide cohort study.

作者信息

Lin Shih-Yi, Lin Cheng-Li, Ju Shu-Woei, Wang I-Kuan, Lin Cheng-Chieh, Lin Chih-Hsueh, Hsu Wu-Huei, Liang Ji-An

机构信息

Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan.

Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung, Taiwan.

出版信息

PLoS One. 2017 Mar 6;12(3):e0173125. doi: 10.1371/journal.pone.0173125. eCollection 2017.

Abstract

PURPOSE

Hepatitis C virus (HCV) infection is associated with increased systemic oxidative stress, which leads to cardiovascular events, diabetes, and chronic kidney disease. Similarly, cataract is also associated with increased oxidative stress. The association between HCV infection and increased risk of cataract remains unclear.

METHODS

A total of 11,652 HCV-infected patients and 46,608 age- and sex-matched non-HCV infected patients were identified during 2003-2011. All patient data were tracked until a diagnosis of cataract, death, or the end of 2011. Cumulative incidences and hazard ratios (HRs) were calculated.

RESULTS

The mean follow-up durations were 5.29 and 5.86 years for the HCV and non-HCV cohorts, respectively. The overall incidence density rate for cataract was 1.36 times higher in the HCV cohort than in the non-HCV cohort (1.86 and 1.37 per 100 person-y, respectively). After adjusting for age, sex, comorbidities of diabetes, hypertension, hyperlipidemia, asthma, chronic obstructive pulmonary disease, coronary artery disease, and anxiety, patients with HCV infection had an increased risk of cataract compared with those without HCV infection [adjusted HR = 1.23, 95% confidence interval (CI) = 1.14-1.32]. HCV-infected patients receiving interferon-ribavirin therapy had a 1.83 times higher (95% CI = 1.40-2.38) risk of cataract than non-HCV infected patients did.

CONCLUSION

HCV infection, even without the complication of cirrhosis, is associated with an increased risk of cataract, and this risk is higher in HCV-infected patients undergoing interferon-ribavirin therapy.

摘要

目的

丙型肝炎病毒(HCV)感染与全身氧化应激增加有关,而氧化应激增加会导致心血管事件、糖尿病和慢性肾病。同样,白内障也与氧化应激增加有关。HCV感染与白内障风险增加之间的关联仍不明确。

方法

在2003年至2011年期间,共确定了11652例HCV感染患者和46608例年龄和性别匹配的非HCV感染患者。跟踪所有患者的数据,直至诊断出白内障、死亡或2011年底。计算累积发病率和风险比(HRs)。

结果

HCV队列和非HCV队列的平均随访时间分别为5.29年和5.86年。HCV队列中白内障的总体发病密度率比非HCV队列高1.36倍(分别为每100人年1.86例和1.37例)。在调整年龄、性别、糖尿病、高血压、高脂血症、哮喘、慢性阻塞性肺疾病、冠状动脉疾病和焦虑症等合并症后,与未感染HCV的患者相比,HCV感染患者患白内障的风险增加[调整后的HR = 1.23,95%置信区间(CI)= 1.14 - 1.32]。接受干扰素-利巴韦林治疗的HCV感染患者患白内障的风险是非HCV感染患者的1.83倍(95% CI = 1.40 - 2.38)。

结论

即使没有肝硬化并发症,HCV感染也与白内障风险增加有关,并且在接受干扰素-利巴韦林治疗的HCV感染患者中这种风险更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d05/5338813/ae71114575e9/pone.0173125.g001.jpg

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