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直接抗病毒治疗对患有精神疾病的慢性丙型肝炎患者是安全有效的。

Direct‑acting antiviral treatment is safe and effective for chronic HCV patients with psychiatric disorders.

作者信息

Okano Hiroshi, Takenaka Takanori, Asakawa Hiroki, Tsuruga Satomi, Kumazawa Hiroaki, Isono Yoshiaki, Tanaka Hiroki, Matsusaki Shimpei, Sase Tomohiro, Saito Tomonori, Mukai Katsumi, Nishimura Akira

机构信息

Department of Gastroenterology, Suzuka General Hospital, Suzuka, Mie 513-8630, Japan.

出版信息

Exp Ther Med. 2023 Jul 7;26(2):402. doi: 10.3892/etm.2023.12100. eCollection 2023 Aug.

Abstract

Although most patients with hepatitis C virus (HCV) infection have been cured since the introduction of direct-acting antiviral (DAA) treatments, whether patients with psychiatric disorders and chronic HCV infection receive benefits from DAA treatments remain unclear. The efficacy and safety of DAA treatment were compared between patients with and without psychiatric disorders. Data were retrospectively collected from medical records at the Suzuka General Hospital (Japan) between September 2014 and December 2021. The study was an observational, single-center study. Fisher's exact test, Mann-Whitney U test and Friedman's test were used for the comparisons between groups. Patients with HCV infection who had been started on DAA treatments were included. In total, 15 HCV cases with psychiatric disorders (P) and 209 HCV cases with nonpsychiatric disorders (NP) were started on DAA treatments for HCV infection. Patients in group P were younger (55±13.9 years) compared with those in group NP (68±13.0 years). A total of 12 patients (80%) in group P achieved and 188 patients (90%) in group NP achieved sustained virologic response (SVR), with no significant difference between the two groups. The remaining three patients in group P who did not achieve SVR included two drop-out cases. Regarding the laboratory data at the end of DAA treatments and SVR, there were no significant differences between the two groups. There were no cases of discontinuation or reduction of medication due to psychiatric disorders during DAA treatment. DAA treatment for HCV infection is effective, tolerable and safe for psychiatric patients, as well as patients without psychiatric disorders. Psychiatric patients with HCV infection should undergo DAA treatment to prevent progression to liver failure and/or cancer.

摘要

尽管自直接作用抗病毒(DAA)治疗问世以来,大多数丙型肝炎病毒(HCV)感染者已被治愈,但患有精神疾病的慢性HCV感染者是否能从DAA治疗中获益仍不清楚。比较了患有和未患有精神疾病的患者接受DAA治疗的疗效和安全性。回顾性收集了2014年9月至2021年12月期间日本铃鹿综合医院病历中的数据。该研究为一项观察性单中心研究。采用Fisher精确检验、Mann-Whitney U检验和Friedman检验进行组间比较。纳入了开始接受DAA治疗的HCV感染者。共有15例患有精神疾病的HCV病例(P组)和209例未患有精神疾病的HCV病例(NP组)开始接受针对HCV感染的DAA治疗。P组患者(55±13.9岁)比NP组患者(68±13.0岁)更年轻。P组共有12例患者(80%)实现了持续病毒学应答(SVR),NP组有188例患者(90%)实现了SVR,两组之间无显著差异。P组中未实现SVR的其余3例患者包括2例退出病例。关于DAA治疗结束时和SVR时的实验室数据,两组之间无显著差异。DAA治疗期间没有因精神疾病而停药或减药的情况。DAA治疗对HCV感染的精神疾病患者以及无精神疾病的患者有效、可耐受且安全。患有HCV感染的精神疾病患者应接受DAA治疗以预防进展为肝衰竭和/或癌症。

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