对于 HCV 感染后已治愈的肝硬化患者，我们是否应继续对其进行肝细胞癌和胃食管静脉曲张监测？

Should we continue surveillance for hepatocellular carcinoma and gastroesophageal varices in patients with cirrhosis and cured HCV infection?

机构信息

Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, the Netherlands; Division of Infectious Diseases, Amsterdam Infection & Immunity Institute Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands.

出版信息

Eur J Intern Med. 2021 Dec;94:6-14. doi: 10.1016/j.ejim.2021.08.023. Epub 2021 Sep 23.

DOI:10.1016/j.ejim.2021.08.023

PMID:34563447

Abstract

Hepatocellular carcinoma (HCC) and variceal bleeding are among the most common causes of liver-related mortality in patients with hepatitis C virus (HCV)-induced cirrhosis. Current guidelines recommend HCC and gastroesophageal varices (GEV) surveillance in patients with HCV infection and cirrhosis. However, since the recent introduction of direct-acting antivirals, most patients with cirrhosis are now cured of their chronic HCV infection. As virological cure is considered to substantially reduce the risk of cirrhosis-related complications, this review discusses the current literature concerning the surveillance of HCC and GEV in patients with HCV-induced cirrhosis with a focus on the setting following sustained virological response.

摘要

肝细胞癌（HCC）和静脉曲张出血是丙型肝炎病毒（HCV）引起的肝硬化患者肝相关死亡的最常见原因之一。目前的指南建议对 HCV 感染和肝硬化患者进行 HCC 和胃食管静脉曲张（GEV）监测。然而，由于直接作用抗病毒药物的近期推出，大多数肝硬化患者现在已经治愈了他们的慢性 HCV 感染。由于病毒学治愈被认为可大大降低肝硬化相关并发症的风险，因此，本综述讨论了目前关于 HCV 诱导的肝硬化患者 HCC 和 GEV 监测的文献，重点是持续病毒学应答后的情况。