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评估丙型肝炎患者接受直接抗病毒药物(DAA)治疗后短期和长期的肝纤维化改善情况。

Evaluating short-term and long-term liver fibrosis improvement in hepatitis C patients post-DAA treatment.

作者信息

Wang Yifan, Ma Xinyan, Zou Yanzheng, Yue Ming, Zhang Meiling, Yu Rongbin, Chen Hongbo, Huang Peng

机构信息

Department of Infectious Disease, Jurong Hospital Affiliated to Jiangsu University, Jurong, Jiangsu, China.

Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China.

出版信息

J Biomed Res. 2024 Mar 21;38(5):1-10. doi: 10.7555/JBR.37.20230284.

Abstract

Despite achieving a high cure rate with direct-acting antivirals (DAAs) in hepatitis C treatment, further research is needed to identify additional benefits of the DAA therapy. The current study evaluated liver fibrosis improvement in 848 hepatitis C patients treated with DAAs, who also achieved sustained virologic response (SVR). Using the fibrosis-4 (FIB-4) index, patients were categorized based on their baseline fibrosis level, and improvements in fibrosis were analyzed in both the short-term (9-26 weeks) and long-term (≥ 36 weeks) follow-up. The results showed a significant decrease in the FIB-4 index, indicating an improvement in liver fibrosis, in 63.00% of the patients during the short-term follow-up and 67.56% during the long-term follow-up. Short-term improvement was associated with factors including ribavirin (RBV) usage, blood cholinesterase levels, alanine transaminase levels, albumin levels, and the baseline FIB-4 index. Additionally, long-term improvement was associated with factors such as aspartate transaminase levels, total protein level, and the baseline FIB-4 index. The current study emphasizes the importance of continuous assessment and post-treatment monitoring of liver fibrosis, providing crucial insights for enhancing patient care in hepatitis C management.

摘要

尽管直接作用抗病毒药物(DAA)在丙型肝炎治疗中取得了较高的治愈率,但仍需要进一步研究以确定DAA疗法的其他益处。本研究评估了848例接受DAA治疗且实现持续病毒学应答(SVR)的丙型肝炎患者的肝纤维化改善情况。使用纤维化-4(FIB-4)指数,根据患者的基线纤维化水平进行分类,并在短期(9 - 26周)和长期(≥36周)随访中分析纤维化的改善情况。结果显示,在短期随访期间,63.00%的患者FIB-4指数显著下降,表明肝纤维化有所改善;在长期随访期间,这一比例为67.56%。短期改善与利巴韦林(RBV)使用、血液胆碱酯酶水平、丙氨酸转氨酶水平、白蛋白水平以及基线FIB-4指数等因素有关。此外,长期改善与天冬氨酸转氨酶水平、总蛋白水平以及基线FIB-4指数等因素有关。本研究强调了对肝纤维化进行持续评估和治疗后监测的重要性,为加强丙型肝炎管理中的患者护理提供了关键见解。

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