Frankova Sona, Uzlova Nikola, Merta Dusan, Pitova Veronika, Sperl Jan
Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, 14021 Prague, Czech Republic.
Department of Internal Medicine, University Hospital Kralovske Vinohrady, 10034 Prague, Czech Republic.
Life (Basel). 2023 Apr 2;13(4):932. doi: 10.3390/life13040932.
HCV infection often remains untreated in people who inject drugs (PWID), albeit they may present with advanced liver fibrosis at a young age. We aimed to assess the rate of patients with significant fibrosis in PWID starting anti-HCV therapy and identify the factors associated with severe fibrosis.
The cohort of 200 patients was divided into two groups: F0-F2 (N = 154, 77%), patients with liver stiffness measurement (LSM) < 10.0 kPa, and F3-F4 (N = 46, 23%), with LSM ≥ 10.0 kPa, indicating significant liver fibrosis.
In group F3-F4, there were significantly more males, and the patients were older, with a higher BMI. The number of long-term abstaining patients was significantly higher in group F3-F4 compared with group F0-F2, as well as the proportion of patients reporting harmful drinking. Obesity (OR 4.77), long-term abstinence from illicit drugs (OR 4.06), harmful drinking (OR 2.83), and older age (OR 1.17) were significant predictors of advanced fibrosis in PWID starting anti-HCV therapy.
A quarter of PWID presented with significant liver fibrosis at treatment initiation. Obesity, long-term drug abstinence, harmful drinking, and older age contributed to significant liver fibrosis.
注射吸毒者（PWID）中的丙型肝炎病毒（HCV）感染常常未得到治疗，尽管他们可能在年轻时就出现严重肝纤维化。我们旨在评估开始抗HCV治疗的PWID中显著纤维化患者的比例，并确定与严重纤维化相关的因素。
200例患者队列分为两组：F0-F2组（N = 154，77%），肝脏硬度测量值（LSM）< 10.0 kPa的患者；F3-F4组（N = 46，23%），LSM≥10.0 kPa，表明存在显著肝纤维化。
F3-F4组男性明显更多，患者年龄更大，体重指数更高。与F0-F2组相比，F3-F4组长期戒毒的患者数量明显更多，报告有害饮酒的患者比例也更高。肥胖（比值比4.77）、长期戒除非法药物（比值比4.06）、有害饮酒（比值比2.83）和年龄较大（比值比1.17）是开始抗HCV治疗的PWID中晚期纤维化的显著预测因素。
四分之一的PWID在开始治疗时就出现显著肝纤维化。肥胖、长期戒毒、有害饮酒和年龄较大是导致显著肝纤维化的因素。
