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接受直接作用抗病毒药物治疗的慢性丙型肝炎患者:这一人群正在发生怎样的变化?

Patients with chronic hepatitis C receiving treatment with direct acting antivirals: How is this population changing?

机构信息

Infectious Diseases I Unit, IRCCS "San Matteo", Via Taramelli 5, 27100 Pavia, Italy; Infectious Diseases I Unit, IRCCS "San Matteo", Pavia, Italy.

Infectious Diseases I Unit, IRCCS "San Matteo", Via Taramelli 5, 27100 Pavia, Italy.

出版信息

Dig Liver Dis. 2021 Apr;53(4):456-460. doi: 10.1016/j.dld.2020.07.013. Epub 2020 Jul 27.

Abstract

BACKGROUND AND AIMS

Direct acting antiviral agents (DAAs) have revolutionized the landscape of chronic hepatitis C (CHC) enabling treatment of all those infected. It remains to be determined how the characteristics of those receiving treatment are changing.

MATERIALS AND METHODS

We retrospectively analysed all the patients with CHC who received treatment with DAAs in a large referral centre since 01/01/2015. We stratified their demographic, clinical and virological characteristics at baseline and the sustained virological response (SVR) rates according to the year of treatment.

RESULTS

In the study were included 2565 patients. During the study period, the yearly proportion of men and cirrhotic patients decreased (p<0.001) whereas mean age increased from 59.8 to 62.2 years old (p=0.04). An increasing trend was observed in the foreign-born patients from 4.3% to 7.9%, without reaching statistical significance. The prevalence of comorbidities had also increased during the study period (p<0.001). Instead, the yearly number of experienced patients decreased significantly (p<0.001) as well as the mean MELD score of cirrhotic patients from 9 to 7.6 (p<0.001). SVR rates increased significantly, from 93.4% in 2015 to 97.1% in 2018 (P<0.05).

CONCLUSIONS

The population of patients with CHC receiving DAAs is becoming older and with more comorbidities. Nevertheless, this did not impact SVR rates.

摘要

背景与目的

直接作用抗病毒药物(DAAs)彻底改变了慢性丙型肝炎(CHC)的治疗格局,使所有感染者都能够接受治疗。然而,接受治疗的患者的特征如何变化仍有待确定。

材料与方法

我们回顾性分析了自 2015 年 1 月 1 日以来,在一家大型转诊中心接受 DAA 治疗的所有 CHC 患者。根据治疗年份,我们对患者的人口统计学、临床和病毒学特征进行分层,并比较其基线和持续病毒学应答(SVR)率。

结果

本研究共纳入 2565 例患者。研究期间,男性和肝硬化患者的比例逐年下降(p<0.001),而平均年龄从 59.8 岁增加到 62.2 岁(p=0.04)。外来出生患者的比例从 4.3%增加到 7.9%,但无统计学意义。研究期间,合并症的患病率也有所增加(p<0.001)。然而,经验丰富的患者人数每年显著减少(p<0.001),肝硬化患者的平均 MELD 评分从 9 分降至 7.6 分(p<0.001)。SVR 率显著提高,从 2015 年的 93.4%提高到 2018 年的 97.1%(p<0.05)。

结论

接受 DAA 治疗的 CHC 患者群体年龄更大,合并症更多。然而,这并未影响 SVR 率。

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