Dąbrowska Maria, Jaroszewicz Jerzy, Sitko Marek, Janocha-Litwin Justyna, Zarębska-Michaluk Dorota, Janczewska Ewa, Lorenc Beata, Tudrujek-Zdunek Magdalena, Parfieniuk-Kowerda Anna, Klapaczyński Jakub, Berak Hanna, Socha Łukasz, Dobracka Beata, Dybowska Dorota, Mazur Włodzimierz, Ważny Łukasz, Flisiak Robert
Department of Infectious Diseases and Hepatology, Medical University of Silesia, 40-635 Katowice, Poland.
Department of Infectious and Tropical Diseases, Jagiellonian University, 30-688 Kraków, Poland.
Cancers (Basel). 2024 Sep 9;16(17):3114. doi: 10.3390/cancers16173114.
Over the past years, the introduction of direct-acting antivirals (DAAs) revolutionized chronic hepatitis C treatment. We aimed to characterize and assess treatment efficacy in three specific groups of patients treated with DAAs: those with active solid malignant tumors (SMTs), hematological diseases (HDs) and hepatocellular carcinomas (HCCs).
A total of 203 patients with active oncological disease (SMT = 61, HD = 67, HCC = 74) during DAA treatment in 2015-2020 selected from the EpiTer-2 database were analyzed retrospectively and compared to 12,983 patients without any active malignancy.
Extrahepatic symptoms were more frequent in HD patients (17.2% vs. SMT = 10.3%, HCC = 8.2%, without = 7.8%, = 0.004). HCC patients characterized with the highest ALT activity (81 IU/L vs. SMT = 59.5 IU/L, HD = 52 IU/L, without = 58 IU/L, = 0.001) more often had F4 fibrosis as well (86.11% vs. SMT = 23.3%, HD = 28.8%, controls = 24.4%, = 0.001). A significant majority of subjects in HCC, HD and SMT populations completed the full treatment plan (HCC = 91%; = 67, HD = 97%; = 65, SMT = 100%; = 62). Concerning the treatment efficacy, the overall sustained virologic response, excluding non-virologic failures, was reported in 93.6% HD, 90.16% SMT and 80.6% in HCC patients.
As presented in our study, DAA therapy has proven to be highly effective and safe in patients with active SMTs and HDs. However, therapy discontinuations resulting from liver disease progression remain to be the major concern in HCC patients.
在过去几年中，直接作用抗病毒药物（DAAs）的引入彻底改变了慢性丙型肝炎的治疗方式。我们旨在对接受DAAs治疗的三类特定患者群体进行特征描述并评估其治疗效果：患有活动性实体恶性肿瘤（SMTs）、血液系统疾病（HDs）和肝细胞癌（HCCs）的患者。
回顾性分析了2015年至2020年期间从EpiTer - 2数据库中选取的203例在接受DAA治疗期间患有活动性肿瘤疾病的患者（SMT = 61例，HD = 67例，HCC = 74例），并与12,983例无任何活动性恶性肿瘤的患者进行比较。
HD患者的肝外症状更为常见（17.2% 对比SMT = 10.3%，HCC = 8.2%，无肿瘤患者 = 7.8%，P = 0.004）。HCC患者的ALT活性最高（81 IU/L 对比SMT = 59.5 IU/L，HD = 52 IU/L，无肿瘤患者 = 58 IU/L，P = 0.001），且更常出现F4纤维化（86.11% 对比SMT = 23.3%，HD = 28.8%，对照组 = 24.4%，P = 0.001）。HCC、HD和SMT群体中的绝大多数受试者完成了完整的治疗计划（HCC = 91%；n = 67，HD = 97%；n = 65，SMT = 100%；n = 62）。关于治疗效果，排除非病毒学失败情况后，HD患者的总体持续病毒学应答率为93.6%，SMT患者为90.16%，HCC患者为80.6%。
如我们的研究所示，DAA疗法在患有活动性SMTs和HDs的患者中已被证明是高度有效且安全的。然而，因肝病进展导致的治疗中断仍是HCC患者的主要担忧。
Zotero 插件
