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客观评估丙型肝炎病毒治疗对肝脏硬度积极影响的非侵入性可靠方法。

Non-Invasive Reliable Methods to Objectify the Positive Influence of Hepatitis C Virus Treatment on Liver Stiffness.

作者信息

Bert Florian, Stahmeyer Jona Theodor, Parpalea Andra-Livia, Rossol Siegbert

机构信息

Department of Internal Medicine, Krankenhaus Nordwest, Frankfurt/Main, Germany.

Institute for Epidemiology, Social Medicine and Health Systems Research, Medical School, Hannover, Germany.

出版信息

Gastroenterology Res. 2021 Feb;14(1):31-40. doi: 10.14740/gr1347. Epub 2021 Feb 19.

Abstract

BACKGROUND

Chronic active hepatitis C virus (HCV) infection is a major public health problem and causes liver fibrosis (LF) up to liver cirrhosis (LC). LF can be estimated by non-invasive, easy handling methods. With implementation of new HCV therapies, elimination rates of HCV are near 100%, resulting in less clinical complications and costs. The aim of our study was to evaluate the positive influence of HCV treatment on liver stiffness by non-invasive assessments of LF.

METHODS

Sixty-two patients with HCV were treated with antiviral drug regimes. Serological fibrosis scores and ultrasound elastography (acoustic radiation force impulse and shear wave elasticity imaging (ARFI-SWEI)) were used for LF assessment on day 0 and 6 months after therapy.

RESULTS

Antiviral treatment was successful in all cases. ARFI-SWEI measurements showed an improvement of all LF stages. Results of serological markers and scores were heterogeneous. Significant positive effects of treatment were seen for aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 (FIB-4) scores, only. Further Pearson's coefficient showed moderate till very high correlations for ARFI-SWEI and FIB-4/APRI scores.

CONCLUSION

Today HCV therapy is able to cure HCV. Positive influences are improvement of LF stages. ARFI-SWEI, APRI and FIB-4 score are useful, easy handling tools to verify positive influence of HCV treatment on LF alone or in combination.

摘要

背景

慢性丙型肝炎病毒(HCV)感染是一个重大的公共卫生问题,可导致肝纤维化(LF)直至肝硬化(LC)。LF可通过非侵入性、易于操作的方法进行评估。随着新型HCV疗法的应用,HCV的清除率接近100%,从而减少了临床并发症和费用。我们研究的目的是通过对LF的非侵入性评估来评价HCV治疗对肝脏硬度的积极影响。

方法

62例HCV患者接受抗病毒药物治疗。在治疗第0天和治疗6个月后,采用血清纤维化评分和超声弹性成像(声辐射力脉冲和剪切波弹性成像(ARFI-SWEI))对LF进行评估。

结果

所有病例的抗病毒治疗均成功。ARFI-SWEI测量显示所有LF阶段均有改善。血清学标志物和评分的结果存在异质性。仅天冬氨酸转氨酶与血小板比值指数(APRI)和纤维化-4(FIB-4)评分显示出治疗的显著积极效果。进一步的Pearson系数显示ARFI-SWEI与FIB-4/APRI评分之间存在中度至高度相关性。

结论

如今HCV疗法能够治愈HCV。积极影响是LF阶段得到改善。ARFI-SWEI、APRI和FIB-4评分是单独或联合验证HCV治疗对LF的积极影响的有用且易于操作的工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/540b/7935613/4288f507f969/gr-14-031-g001.jpg

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