Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan 333, Taiwan.
College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
Viruses. 2022 Apr 10;14(4):786. doi: 10.3390/v14040786.
Introduction: High sustained virological response (SVR) rate (>95%) and liver stiffness regression can be achieved with direct acting antivirals treatment (DAA) in patients with chronic hepatitis C virus (CHC) infection. Reactivation of hepatitis B virus (HBV) was reported during DAA treatment in patients co-infected with HBV, although its impact on liver stiffness remains unknown. This study aims to investigate whether the liver stiffness (LSM) regression is different between HBV/HCV co-infected and mono-HCV-infected patients. Materials and Methods: CHC patients with/without HBV co-infection who received DAA treatment and achieved SVR12 between March 2015 and December 2019 in Chang Gung Memorial Hospital, Linkou branch were prospectively enrolled. LSM was assessed by transient elastography (TE, Fibroscan) at baseline and after SVR. Propensity score matching (PSM) at 3:1 ratio, adjusted for age, gender, pre-DAA alanine aminotransferase (ALT), platelet count, and LSM, between CHC with and without HBV co-infection, was performed before further analysis. Results: Among 906 CHC patients enrolled, 52 (5.7%) patients had HBV/HCV co-infection. Patients with HBV/HCV co-infection were of younger age (61.8 vs. 63.2, p = 0.31), with a higher proportion of males (53.8% vs. 38.9%, p = 0.03), and lower pretreatment LSM level (8.15 vs. 10.2 kPa, p = 0.09), while other features were comparable. After PSM, patients with HBV/HCV co-infection had insignificantly lower LSM regression compared to mono-HCV-infected patients (−0.85 kPa vs. −1.65 kPa, p = 0.250). Conclusions: The co-infection of HBV among CHC patients has limited impact on liver stiffness regression after successful DAA treatment.
慢性丙型肝炎病毒（CHC）感染患者接受直接作用抗病毒药物（DAA）治疗可获得高持续病毒学应答（SVR）率（>95%）和肝硬度消退。在 HBV 合并感染的患者中，DAA 治疗期间曾有报道 HBV 再激活，尽管其对肝硬度的影响尚不清楚。本研究旨在探讨 HBV/HCV 合并感染和单纯 HCV 感染患者的肝硬度（LSM）消退是否存在差异。
2015 年 3 月至 2019 年 12 月，在长庚纪念医院林口分院接受 DAA 治疗并获得 SVR12 的 CHC 患者，前瞻性纳入本研究。采用瞬时弹性成像（TE，Fibroscan）于基线和 SVR 后评估 LSM。采用倾向评分匹配（PSM）以 3:1 的比例，对年龄、性别、DAA 前丙氨酸氨基转移酶（ALT）、血小板计数和 LSM 进行调整，在进一步分析之前，比较 CHC 合并和不合并 HBV 感染患者。
共纳入 906 例 CHC 患者，其中 52 例（5.7%）患者存在 HBV/HCV 合并感染。HBV/HCV 合并感染患者年龄较小（61.8 岁 vs. 63.2 岁，p = 0.31），男性比例较高（53.8% vs. 38.9%，p = 0.03），治疗前 LSM 水平较低（8.15 kPa vs. 10.2 kPa，p = 0.09），而其他特征无显著差异。PSM 后，与单纯 HCV 感染患者相比，HBV/HCV 合并感染患者的 LSM 消退程度无显著差异（-0.85 kPa vs. -1.65 kPa，p = 0.250）。
CHC 患者的 HBV 合并感染对 DAA 治疗后肝硬度消退的影响有限。
