Nahon Pierre, Ganne-Carrié Nathalie
AP-HP, Hôpital Jean Verdier, Liver Unit, Bondy, France.
University Paris 13, Sorbonne Paris Cité, "équipe labellisée Ligue Contre le Cancer", F-93000 Bobigny, France.
JHEP Rep. 2019 Nov 18;1(6):480-489. doi: 10.1016/j.jhepr.2019.11.001. eCollection 2019 Dec.
Patients with HCV-related bridging fibrosis or cirrhosis remain at risk of developing life-threatening complications even after achieving a sustained virological response. Although it is reduced, the risk of liver-related events in these patients justifies their inclusion in surveillance programmes dedicated to the early detection of hepatocellular carcinoma and the screening for portal hypertension. Biochemical parameters or non-invasive tests might indicate the potential progression of liver injury despite viral clearance. Specific attention must be focused on the management of comorbidities, while dedicated educational programmes must be encouraged to increase compliance and commitment to surveillance. Better knowledge of the long-term evolution of these patients, who now live longer, is essential to improve risk stratification and refine screening strategies in this growing population.
即使实现了持续病毒学应答，丙型肝炎病毒（HCV）相关桥接纤维化或肝硬化患者仍有发生危及生命并发症的风险。尽管风险有所降低，但这些患者发生肝脏相关事件的风险仍表明应将他们纳入专门用于早期检测肝细胞癌和筛查门静脉高压的监测计划。尽管病毒已清除，但生化参数或非侵入性检查可能表明肝损伤有潜在进展。必须特别关注合并症的管理，同时应鼓励开展专门的教育计划，以提高对监测的依从性和重视程度。更好地了解这些现在寿命更长的患者的长期病情演变，对于改善这一不断增长的人群的风险分层和优化筛查策略至关重要。
