Department of Emergency Medicine, Santa Lucía University Hospital, 30202 Cartagena, Spain.
Department of Gastroenterology and Hepatology, Santa Lucía University Hospital, 30202 Cartagena, Spain.
Medicina (Kaunas). 2023 Apr 21;59(4):814. doi: 10.3390/medicina59040814.
: The global prevalence of chronic hepatitis C virus (HCV) infection is 0.8%, affecting around 58 million people worldwide. Treatment with DAAs reduces all-cause HCV mortality by 49-68%. This work aims to determine whether there is liver fibrosis regression (LFR) in patients who achieved Sustained Virological Response (SVR) after treatment with DAAs. : An analytical, observational, single-center, and cohort study was carried out. The final sample consisted of 248 HCV-infected patients. All started treatment with DAAs between January 2015 and December 2017. Five measurements were performed to determine the fibrotic stage in patients (measured in kilopascals (kPa)) using transient elastography (FibroScan, Echosens, The Netherlands). : Taking the baseline fibrotic stage as a reference, the distribution in subgroups was as follows: 77 F4 patients (31.0%); 55 F3 patients (22.2%); 53 F2 patients (21.4%); and 63 F0/F1 patients (25.4%). There were 40 patients (16.1%) with at least one HCV complication and 13 (5.2%) who developed hepatocellular carcinoma. The overall LFR rate was 77.8% (144 of 185 F2/F3/F4 patients, = 0.01) at the end of the follow-up period. The highest mean FibroScan values were observed in patients with: "male gender"; "metabolic syndrome"; "subtype 1a"; "NRP DAA"; "at least one HCV complication"; "death from HCV complications"; and "liver transplantation requirement". : Treatment with DAAs achieved high rates of LFR and a decrease in mean FibroScan values in all subgroups.
慢性丙型肝炎病毒(HCV)感染的全球患病率为 0.8%,影响全球约 5800 万人。用直接作用抗病毒药物(DAA)治疗可使 HCV 全因死亡率降低 49%-68%。本研究旨在确定 DAA 治疗后获得持续病毒学应答(SVR)的患者是否存在肝纤维化消退(LFR)。
进行了一项分析性、观察性、单中心和队列研究。最终样本包括 248 例 HCV 感染患者。所有患者均于 2015 年 1 月至 2017 年 12 月期间开始用 DAA 治疗。采用瞬时弹性成像(FibroScan,Echosens,荷兰)对患者的纤维化分期进行了 5 次测量(以千帕斯卡(kPa)为单位)。
以基线纤维化分期为参考,亚组分布如下:77 例 F4 患者(31.0%);55 例 F3 患者(22.2%);53 例 F2 患者(21.4%);63 例 F0/F1 患者(25.4%)。40 例患者(16.1%)至少有 1 种 HCV 并发症,13 例(5.2%)发生肝细胞癌。在随访期末,总的 LFR 率为 77.8%(185 例 F2/F3/F4 患者中的 144 例, = 0.01)。在有以下特征的患者中观察到最高的平均 FibroScan 值:“男性”;“代谢综合征”;“1a 型”;“NRP DAA”;“至少有 1 种 HCV 并发症”;“因 HCV 并发症死亡”;“需要肝移植”。
用 DAA 治疗可使所有亚组获得较高的 LFR 率和平均 FibroScan 值降低。