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意大利 HCV 感染者与接受治疗的本地患者的临床特征和合并症模式: PITER 队列的真实评估。

Clinical features and comorbidity pattern of HCV infected migrants compared to native patients in care in Italy: A real-life evaluation of the PITER cohort.

机构信息

Center for Global Health, Istituto Superiore di Sanità, Rome, Italy.

University of Tor Vergata, Nostra Signora del Buon Consiglio di Tirana, Albania.

出版信息

Dig Liver Dis. 2021 Dec;53(12):1603-1609. doi: 10.1016/j.dld.2021.03.020. Epub 2021 Apr 21.

Abstract

BACKGROUND

Direct-acting antivirals are highly effective for the treatment of hepatitis C virus (HCV) infection, regardless race/ethnicity. We aimed to evaluate demographic, virological and clinical data of HCV-infected migrants vs. natives consecutively enrolled in the PITER cohort.

METHODS

Migrants were defined by country of birth and nationality that was different from Italy. Mann-Whitney U test, Chi-squared test and multiple logistic regression were used.

RESULTS

Of 10,669 enrolled patients, 301 (2.8%) were migrants: median age 47 vs. 62 years, (p < 0.001), females 56.5% vs. 45.3%, (p < 0.001), HBsAg positivity 3.8% vs. 1.4%, (p < 0.05). Genotype 1b was prevalent in both groups, whereas genotype 4 was more prevalent in migrants (p < 0.05). Liver disease severity and sustained virologic response (SVR) were similar. A higher prevalence of comorbidities was reported for natives compared to migrants (p < 0.05). Liver disease progression cofactors (HBsAg, HIV coinfection, alcohol abuse, potential metabolic syndrome) were present in 39.1% and 47.1% (p > 0.05) of migrants and natives who eradicated HCV, respectively.

CONCLUSION

Compared to natives, HCV-infected migrants in care have different demographics, HCV genotypes, viral coinfections and comorbidities and similar disease severity, SVR and cofactors for disease progression after HCV eradication. A periodic clinical assessment after HCV eradication in Italians and migrants with cofactors for disease progression is warranted.

摘要

背景

直接作用抗病毒药物对于治疗丙型肝炎病毒(HCV)感染非常有效,与种族/民族无关。我们旨在评估连续纳入 PITER 队列的 HCV 感染移民与本地人之间的人口统计学、病毒学和临床数据。

方法

移民定义为出生国和国籍与意大利不同的人。使用 Mann-Whitney U 检验、卡方检验和多因素逻辑回归。

结果

在纳入的 10669 名患者中,有 301 名(2.8%)是移民:中位年龄 47 岁与 62 岁(p<0.001),女性占 56.5%与 45.3%(p<0.001),HBsAg 阳性率 3.8%与 1.4%(p<0.05)。两组中均以基因型 1b 为主,而基因型 4 在移民中更为常见(p<0.05)。肝脏疾病严重程度和持续病毒学应答(SVR)相似。与移民相比,本地人报告的合并症更为常见(p<0.05)。在消除 HCV 的移民和本地人中,分别有 39.1%和 47.1%(p>0.05)存在肝脏疾病进展的共同危险因素(HBsAg、HIV 合并感染、酒精滥用、潜在代谢综合征)。

结论

与本地人相比,接受治疗的 HCV 感染移民具有不同的人口统计学特征、HCV 基因型、病毒合并感染和合并症,但疾病严重程度、SVR 和消除 HCV 后疾病进展的共同危险因素相似。在 HCV 消除后,需要对意大利人和有疾病进展共同危险因素的移民进行定期临床评估。

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