基因型分布和爱沙尼亚、拉脱维亚、立陶宛和乌克兰慢性丙型肝炎感染特征：RESPOND-C 研究。

Genotype Distribution and Characteristics of Chronic Hepatitis C Infection in Estonia, Latvia, Lithuania, and Ukraine: The RESPOND-C Study.

机构信息

Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius University Hospital Santaros Klinikos, LT-08406 Vilnius, Lithuania.

Latvian Centre of Infectious Diseases, Riga East Clinical University Hospital, LV-1006 Riga, Latvia.

出版信息

Medicina (Kaunas). 2023 Aug 30;59(9):1577. doi: 10.3390/medicina59091577.

DOI:10.3390/medicina59091577

PMID:37763696

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10534763/

Abstract

Since 2013, highly effective direct-acting antiviral (DAA) treatment for chronic hepatitis C (CHC) has become available, with cure rates exceeding 95%. For the choice of optimal CHC treatment, an assessment of the hepatitis C virus (HCV) genotype (GT) and liver fibrosis stage is necessary. Information about the distribution of these parameters among CHC patients in Estonia, Latvia, and Lithuania (the Baltic states) and especially in Ukraine is scarce. This study was performed to obtain epidemiologic data regarding CHC GT and fibrosis stage distribution for better planning of resources and prioritization of patients for DAA drug treatment according to disease severity in high-income (the Baltic states) and lower-middle-income (Ukraine) countries. The retrospective RESPOND-C study included 1451 CHC patients. Demographic and disease information was collected from medical charts for each patient. The most common suspected mode of viral transmission was blood transfusions (17.8%), followed by intravenous substance use (15.7%); however, in 50.9% of patients, the exact mode of transmission was not clarified. In Ukraine (18.4%) and Estonia (26%), transmission by intravenous substance use was higher than in Lithuania (5%) and Latvia (5.3%). Distribution of HCV GT among patients with CHC was as follows: GT1-66.4%; GT3-28.1; and GT2-4.1%. The prevalence of GT1 was the highest in Latvia (84%) and the lowest in Ukraine (63%, < 0.001). Liver fibrosis stages were distributed as follows: F0-12.2%, F1-26.3%, F2-23.5%, F3-17.1%, and F4-20.9%. Cirrhosis (F4) was more prevalent in Lithuanian patients (30.1%) than in Estonians (8.1%, < 0.001). This study contributes to the knowledge of epidemiologic characteristics of HCV infection in the Baltic states and Ukraine. The data regarding the patterns of HCV GT and fibrosis stage distribution will be helpful for the development of national strategies to control HCV infection in the era of DAA therapy.

摘要

自 2013 年以来，已经出现了高效的直接作用抗病毒（DAA）治疗慢性丙型肝炎（CHC）的方法，治愈率超过 95%。对于 CHC 治疗的最佳选择，需要评估丙型肝炎病毒（HCV）基因型（GT）和肝纤维化分期。有关爱沙尼亚、拉脱维亚和立陶宛（波罗的海国家）以及乌克兰 CHC 患者中这些参数分布的信息很少。进行这项研究是为了获得有关 CHC GT 和纤维化分期分布的流行病学数据，以便根据疾病严重程度更好地规划资源，并为高收入（波罗的海国家）和中低收入（乌克兰）国家的 DAA 药物治疗患者确定优先次序。这项回顾性 RESPOND-C 研究纳入了 1451 例 CHC 患者。从每位患者的病历中收集了人口统计学和疾病信息。最常见的疑似病毒传播途径是输血（17.8%），其次是静脉内药物滥用（15.7%）；然而，在 50.9%的患者中，确切的传播途径尚不清楚。在乌克兰（18.4%）和爱沙尼亚（26%），静脉内药物滥用传播的比例高于立陶宛（5%）和拉脱维亚（5.3%）。CHC 患者中 HCV GT 的分布情况如下：GT1-66.4%；GT3-28.1%；和 GT2-4.1%。拉脱维亚（84%）的 GT1 患病率最高，乌克兰（63%，<0.001）的最低。肝纤维化分期分布如下：F0-12.2%；F1-26.3%；F2-23.5%；F3-17.1%；和 F4-20.9%。肝硬化（F4）在立陶宛患者中更为常见（30.1%），而在爱沙尼亚患者中则较少见（8.1%，<0.001）。这项研究有助于了解波罗的海国家和乌克兰 HCV 感染的流行病学特征。关于 HCV GT 和纤维化分期分布模式的数据将有助于制定 DAA 治疗时代控制 HCV 感染的国家战略。