埃及患者丙型肝炎病毒清除对肝硬度的长期影响。
Long-Term Impact of Hepatitis C Virus Eradication on Liver Stiffness in Egyptian Patients.
机构信息
Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Shebeen El-Kom, Egypt.
Radiology Department, National Liver Institute, Menoufia University, Shebeen El-Kom, Egypt.
出版信息
Can J Gastroenterol Hepatol. 2021 Sep 20;2021:4961919. doi: 10.1155/2021/4961919. eCollection 2021.
METHODS
Liver stiffness measurements (LSM) have been serially assessed 1, 3, and 5 years after HCV clearance in 655 patients who have been treated with DAAs.
RESULTS
The mean age was 51.44 ± 10 years. 73% of patients were males. 48% were cirrhotics. In noncirrhotics, the mean LSM was significantly decreased from 8.29 ± 2.3 kPa to 4.03 ± 1.0 kPa ( < 0.0001) at the end of the follow-up. Likewise, LSM decreased in cirrhotics from 29.66 ± 14.25 kPa to 22.50 ± 11.16 kPa ( < 0.0001). The proportions of 1, 2, 3, and 4 patients at the baseline were 17.7%, 17.9%, 16.6%, and 47.8%, which became 56.5%, 4.1%, 4.9%, and 34.5%, respectively, with a substantial reversal of cirrhosis in 87 patients (27.7%) at the end of follow-up.
CONCLUSIONS
There was an overall significant regression of liver stiffness in all patients after sustained HCV eradication. Liver stiffness reflecting mild fibrosis (0-2) usually improves shortly after treatment, while measurements reflecting advanced fibrosis (3-4) take a longer time to regress to lower fibrosis stages.
方法
655 例接受 DAA 治疗的 HCV 清除患者，在 HCV 清除后 1、3 和 5 年时连续评估肝硬度值（LSM）。
结果
患者平均年龄为 51.44±10 岁，73%为男性，48%为肝硬化患者。在非肝硬化患者中，LSM 从治疗结束时的 8.29±2.3kPa 显著降低至 4.03±1.0kPa（<0.0001）；同样，肝硬化患者的 LSM 从 29.66±14.25kPa 降低至 22.50±11.16kPa（<0.0001）。治疗基线时的患者比例为 17.7%、17.9%、16.6%和 47.8%，治疗结束时分别为 56.5%、4.1%、4.9%和 34.5%，87 例（27.7%）患者肝硬化得到了显著逆转。
结论
所有患者在持续清除 HCV 后，LSM 总体均有显著下降。反映轻度纤维化（0-2）的 LSM 通常在治疗后短期内改善，而反映晚期纤维化（3-4）的测量值则需要更长时间才能下降到较低的纤维化阶段。
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