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采用多种治疗策略根除伊朗地中海贫血患者的丙型肝炎病毒感染。

Eradication of hepatitis C virus infection in thalassemia patients in Iran using various treatment strategies.

作者信息

Moghimbeygi Meisam, Alavian Seyed Moayed

机构信息

Department of Mathematics, Faculty of Mathematics and Computer Science, Kharazmi University, Tehran, Iran.

Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran.

出版信息

J Virus Erad. 2020 Aug 5;6(3):100006. doi: 10.1016/j.jve.2020.100006. eCollection 2020 Sep.

Abstract

BACKGROUND

Chronic hepatitis C virus (HCV) infection is considered as one of the leading causes of liver disease in thalassemic patients in Iran. Over 40% of the mortality in these patients is related to HCV.

OBJECTIVES

The present study aimed at estimating HCV prevalence in thalassemic patients in Iran and to determine the number of infections until eradication is achieved.

METHODS

A meta-analysis approach was used to estimate the number of HCV-infected thalassemic patients in the country. The prevalence rate was measured using a modeling approach to predict the number of cases until eradication using several scenarios in terms of testing and treatment, in particular the use of direct acting antiviral drugs (DAAs).

RESULTS

With the advent of DAAs with a high rate of treatment success, HCV could be eradicated earlier than originally thought among this group of patients. Based on previous predictions the number of HCV-infected thalassemic patients would have been below 66 by 2020. However, according to our predictions, the number will be less than 10 when using DAAs.

CONCLUSION

We believe that HCV eradication can be achieved in thalassemic patients with an increased life expectancy by funding DAA-based new treatment strategies. This has been exemplified in Alborz, Lorestan, and South Khorasan provinces with HCV eradication in this group of patients.

摘要

背景

慢性丙型肝炎病毒(HCV)感染被认为是伊朗地中海贫血患者肝病的主要病因之一。这些患者中超过40%的死亡率与HCV有关。

目的

本研究旨在估计伊朗地中海贫血患者中HCV的患病率,并确定在实现根除之前的感染病例数。

方法

采用荟萃分析方法估计该国HCV感染的地中海贫血患者数量。患病率通过建模方法测量,以预测在不同检测和治疗方案下,特别是使用直接抗病毒药物(DAA)的情况下,直至根除的病例数。

结果

随着治疗成功率高的DAA的出现,HCV在这组患者中可以比原计划更早根除。根据之前的预测,到2020年,HCV感染的地中海贫血患者数量将低于66例。然而,根据我们的预测,使用DAA时该数量将少于10例。

结论

我们认为,通过资助基于DAA的新治疗策略,可在预期寿命增加的地中海贫血患者中实现HCV根除。阿尔伯兹省、洛雷斯坦省和南呼罗珊省在这组患者中实现HCV根除就是例证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5694/7646675/4f19afe263fb/gr1.jpg

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