慢性丙型肝炎的流行病学正在发生变化：患者在诊断时年龄更大，且处于更晚期。

Changing epidemiology of chronic hepatitis C: patients are older and at a more advanced stage at the time of diagnosis.

机构信息

Department of Gastroenterology, Medical Faculty, Biruni University, Departments of.

Department of Internal Medicine, IU Istanbul Medical Faculty, Istanbul, Turkey.

出版信息

Eur J Gastroenterol Hepatol. 2019 Oct;31(10):1247-1249. doi: 10.1097/MEG.0000000000001406.

DOI:10.1097/MEG.0000000000001406

PMID:30913053

Abstract

INTRODUCTION AND AIM

Over the years, there has been a change in the profile of patients with chronic hepatitis C (CHC). In recent years, more patients with CHC have presented to the clinics at the cirrhotic stage, with decompensated liver disease, and with hepatocellular carcinoma. The aim of this study was to investigate the changing epidemiological, clinical, and virological characteristics of CHC patients.

PATIENTS AND METHODS

A total of 313 CHC patients were included in this study. The patients were classified into group 1 (1996-2001) and group 2 (2011-2016). Epidemiological, clinical, and virological differences were investigated between two periods.

RESULTS

Overall, 44.7% (n = 140) of the patients were in group 1. The sex distribution between the two groups was similar. The patients in group 2 was older than those in group 1 (54 ± 15 vs. 45 ± 12 years, retrospectively, P < 0.001). Whereas 19.8% of the patients in group 1 were treatment-experienced, this rate was found to be 35.5% in group 2 (P = 0.01). Patients who presented in the first period had fewer comorbidities compared with group 2 (P < 0.001). More patients in group 2 had liver cirrhosis than group 1 (45.1 vs. 18.6%, respectively, P < 0.001). Among the patients with cirrhosis, the rate of decompensation was higher in group 2 (46.7 vs. 23.3%, P = 0.03). The presence of hepatocellular carcinoma was significantly higher in group 2 than group 1 (12.8 vs. 3.6%, respectively, P = 0.004).

CONCLUSION

In recent years, CHC patients have presented to hospitals with advanced stage of liver disease; these patients are older and have more comorbidities.

摘要

简介和目的

多年来，慢性丙型肝炎（CHC）患者的特征发生了变化。近年来，更多的 CHC 患者在肝硬化阶段、肝功能失代偿和肝细胞癌就诊于临床。本研究旨在探讨 CHC 患者的流行病学、临床和病毒学特征的变化。

患者和方法

本研究共纳入 313 例 CHC 患者。将患者分为第 1 组（1996-2001 年）和第 2 组（2011-2016 年）。在两个时期之间调查了流行病学、临床和病毒学差异。

结果

总体而言，44.7%（n = 140）的患者在第 1 组。两组的性别分布相似。第 2 组的患者年龄大于第 1 组（54 ± 15 与 45 ± 12 岁，回顾性，P < 0.001）。第 1 组中有 19.8%的患者为治疗经验者，而第 2 组中这一比例为 35.5%（P = 0.01）。第 1 个时期就诊的患者比第 2 组有更少的合并症（P < 0.001）。第 2 组的患者中有更多的肝硬化患者比第 1 组（分别为 45.1%和 18.6%，P < 0.001）。在肝硬化患者中，第 2 组的失代偿率更高（46.7%与 23.3%，P = 0.03）。第 2 组的肝细胞癌发生率明显高于第 1 组（分别为 12.8%和 3.6%，P = 0.004）。