Department of Medical Specialties (I), Faculty of Medicine, "Grigore T. Popa" Universityof Medicine and Pharmacy, 700111 Iași, Romania.
Department of Medical Specialties (II), Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700111 Iași, Romania.
Medicina (Kaunas). 2021 Oct 24;57(11):1153. doi: 10.3390/medicina57111153.
: Hepatic diseases are an important public health problem. All patients with chronic hepatitis C virus (HCV) infection receive treatment, regardless of hepatic fibrosis severity. However, evaluation of hepatic fibrosis and steatosis is still useful in assessing evolution, prognosis and monitoring of hepatic disease, especially after treatment with direct-acting antivirals (DAAs). The aim of this study was to assess the link between patatin-like phospholipase domain-containing 3 (PNPLA3) polymorphism and the degree of hepatic steatosis and fibrosis in patients with chronic HCV infection, as well as changes in steatosis and fibrosis three monthsafter obtaining a sustained viral response (SVR). :Ourstudy included 100 patients with chronic hepatitis C (CHC) infection and compensated cirrhosis who received DAA treatment and who were evaluated using Fibromax prior to and 3 months after SVR. The influence of PNPLA3 (CC, CG, GG) genotype among these patients on the degree of post-treatment regression of steatosis and fibrosis was assessed. : Regression was noticed in the degree of both hepatic steatosis and hepatic fibrosis post-DAA treatment (three months after SVR). Analysis of the correlation between PNPLA3 genotype and fibrosis indicated that the average level of fibrosis (F) before DAA treatment was higher in patients with the GG genotype than in patients with the CC or CG genotype. Three months after SVR, the average level of fibrosis decreased; however, it remained significantly increased in GG subjects compared to that in CC or CG patients. The degree of hepatic steatosis before treatment was not significantly different among patients with different PNPLA3 genotypes, and no significant correlations were observed three months after SVR. : The genetic variants of PNPLA3 influence the evolution of hepatic fibrosis. The GG subtype plays an important role in the degree of hepatic fibrosis both before and after treatment (three months after SVR)and could be a prognostic marker for assessment of post-SVR evolution.
: 肝脏疾病是一个重要的公共卫生问题。所有慢性丙型肝炎病毒（HCV）感染患者均接受治疗，无论肝纤维化严重程度如何。然而，评估肝纤维化和脂肪变性对于评估疾病的演变、预后和监测仍然是有用的，特别是在接受直接作用抗病毒药物（DAA）治疗之后。本研究旨在评估载脂蛋白样磷脂酶域包含蛋白 3（PNPLA3）多态性与慢性 HCV 感染患者肝脂肪变性和纤维化程度之间的关系，以及在获得持续病毒学应答（SVR）后 3 个月时脂肪变性和纤维化的变化。: 我们的研究纳入了 100 例接受 DAA 治疗的慢性丙型肝炎（CHC）感染和代偿性肝硬化患者，并在 SVR 之前和之后 3 个月使用 Fibromax 进行评估。评估这些患者中 PNPLA3（CC、CG、GG）基因型对治疗后脂肪变性和纤维化消退程度的影响。: 在 DAA 治疗后，肝脂肪变性和肝纤维化的程度均出现消退（SVR 后 3 个月）。对 PNPLA3 基因型与纤维化之间的相关性进行分析，结果表明，在 DAA 治疗之前，GG 基因型患者的平均纤维化（F）水平高于 CC 或 CG 基因型患者。SVR 后 3 个月，平均纤维化水平降低；然而，与 CC 或 CG 患者相比，GG 患者的纤维化水平仍显著升高。在治疗前，不同 PNPLA3 基因型患者的肝脂肪变性程度没有显著差异，并且在 SVR 后 3 个月时也没有观察到显著相关性。: PNPLA3 的遗传变异影响肝纤维化的演变。GG 亚型在治疗前后（SVR 后 3 个月）均对肝纤维化程度具有重要作用，并且可能是评估 SVR 后演变的预后标志物。
