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在接受直接抗病毒药物治疗后,HCV 和 HIV/HCV 感染患者的肝硬度和 CXCL4、TGF-β1 和 HGF 的变化相似。

Modifications of liver stiffness and CXCL4, TGF-β1 and HGF are similar in HCV- and HIV/HCV-infected patients after DAAs.

机构信息

Servicio de Medicina Interna y Enfermedades Infecciosas, Facultad de Medicina, Hospital Universitario Puerta del Mar, Instituto para la Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), Universidad de Cádiz, Avda Ana de Viya s/n, 11009, Cádiz, Spain.

Servicio de Aparato Digestivo, Hospital Universitario Puerta del Mar, Instituto para la Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), Cádiz, Spain.

出版信息

Sci Rep. 2021 May 10;11(1):9824. doi: 10.1038/s41598-021-89370-6.

Abstract

The objective of this work was to identify predictive factors of fibrosis regression after direct antiviral agents (DAAs) in HCV-monoinfected and HIV/HCV-coinfected patients. This was a prospective study of HCV-monoinfected (n = 20), HIV/HCV-co-infected (n = 66) patients and healthy controls (n = 15). Patients had started DAAs and achieved sustained virological response. Liver stiffness (LS) and serum concentrations of profibrotic transforming growth factor (TGF)-β1 and CXC chemokine ligand 4 (CXCL4) and antifibrotic HGF hepatocyte growth factor (HGF) were analyzed at baseline (M0) and 12 months after starting DAAs (M12). A M12 LS achievement of ≤ 9.5 kPa was considered the cutoff point to discharge from a liver clinic. The LS decrease from M0 to M12 was 34%. No significant differences were observed in LS decline between HCV- and HIV/HCV-infected individuals. Changes of serum CXCL4, TGF-β1 and HGF levels did not correlate with LS improvement. 16 out from 56 patients (28%) with a baseline LS > 9.5 achieved a M12 LS ≤ 9.5. HCV-monoinfected and HIV/HCV coinfected patients experienced a significant reduction of LS after sustained virological response. This improvement did not correlate with changes in serum profibrotic or antifibrotic markers. A 29% of those with a baseline LS > 9.5 achieved a LS under this cutoff point.

摘要

本研究旨在确定 HCV 单感染和 HIV/HCV 共感染患者接受直接抗病毒药物 (DAA) 治疗后纤维化消退的预测因素。这是一项前瞻性研究,纳入了 HCV 单感染 (n=20)、HIV/HCV 共感染 (n=66) 患者和健康对照者 (n=15)。患者开始接受 DAA 治疗并获得持续病毒学应答。在基线 (M0) 和开始 DAA 治疗后 12 个月 (M12) 时,分析了肝硬度 (LS) 和血清中促纤维化转化生长因子 (TGF)-β1、趋化因子配体 4 (CXCL4) 及抗纤维化肝细胞生长因子 (HGF) 的浓度。将 M12 LS 达到≤9.5kPa 定义为从肝脏诊所出院的截止点。从 M0 到 M12,LS 下降了 34%。在 HCV 和 HIV/HCV 感染个体之间,LS 下降没有显著差异。血清 CXCL4、TGF-β1 和 HGF 水平的变化与 LS 改善无关。在基线 LS>9.5kPa 的 56 例患者中,有 16 例 (28%) 在 M12 时 LS≤9.5kPa。HCV 单感染和 HIV/HCV 共感染患者在获得持续病毒学应答后 LS 显著降低。这种改善与血清促纤维化或抗纤维化标志物的变化无关。在基线 LS>9.5kPa 的患者中,有 29% 的患者 LS 达到了这个截断值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2adf/8110591/639a0c845df4/41598_2021_89370_Fig1_HTML.jpg

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