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脂肪性肝病患者丙型肝炎病毒感染的治疗

Treatment of HCV infection in patients with steatotic liver disease.

作者信息

Flisiak Robert, Zarębska-Michaluk Dorota, Dobrowolska Krystyna, Janocha-Litwin Justyna, Dybowska Dorota, Sitko Marek, Socha Łukasz, Lorenc Beata, Klapaczyński Jakub, Brodowski Jakub

机构信息

Department of Infectious Diseases and Hepatology, Medical University of Białystok, Poland.

Department of Infectious Diseases and Allergology, Jan Kochanowski University, Kielce, Poland.

出版信息

Clin Exp Hepatol. 2024 Sep;10(3):159-164. doi: 10.5114/ceh.2024.141699. Epub 2024 Jul 23.

Abstract

AIM OF THE STUDY

The aim of the study was to characterize the population with hepatitis C virus (HCV) infection and steatotic liver disease (SLD) in comparison to the non-SLD HCV-infected patients and to evaluate the effectiveness of treatment with direct-acting antivirals (DAA).

MATERIAL AND METHODS

The analysis included 62 patients diagnosed with SLD and 14,284 non-SLD patients from the EpiTer-2 database for the period 2015-2022.

RESULTS

Unlike the non-SLD population, the SLD group was dominated by men (49.5% vs. 53.2%, respectively). The mean age of patients did not differ significantly between groups and was 50.8 ±13.8 and 50.8 ±14.9 years for SLD and non-SLD, respectively. As expected, patients with SLD had significantly different BMI values. Genotype (GT) 1b infection predominated in both populations, but the prevalence of GT3 was significantly higher in the SLD group (19.4% vs. 10.6%). The percentage of patients with advanced liver disease (F3/4) was similar in both groups (38.7% vs. 35.6%). Patients with SLD were more likely to be treatment naïve (82.3% vs. 80.5%), HBV co-infected (24.2% vs. 13.6%), and obese (54.8% vs. 17.1%). Out of 62 patients, 59 (95%) achieved a sustained virologic response (SVR), but after excluding 3 lost to follow-up a response rate of 100% was obtained. The corresponding SVR values in the non-SLD HCV-infected population were 95% and 98%, respectively.

CONCLUSIONS

Despite some differences in the characteristics of patients with SLD infected with HCV, the effec-tiveness of DAA therapy does not differ significantly from that observed in the general population infected with HCV.

摘要

研究目的

本研究旨在对丙型肝炎病毒(HCV)感染合并脂肪性肝病(SLD)的人群进行特征描述,并与未合并SLD的HCV感染患者进行比较,同时评估直接抗病毒药物(DAA)治疗的有效性。

材料与方法

分析纳入了2015年至2022年期间来自EpiTer-2数据库的62例诊断为SLD的患者和14284例未合并SLD的患者。

结果

与未合并SLD的人群不同,SLD组以男性为主(分别为49.5%和53.2%)。两组患者的平均年龄无显著差异,SLD组和未合并SLD组分别为50.8±13.8岁和50.8±14.9岁。正如预期的那样,SLD患者的BMI值有显著差异。基因型(GT)1b感染在两组人群中均占主导,但GT3在SLD组中的患病率显著更高(19.4%对10.6%)。两组中晚期肝病(F3/4)患者的比例相似(38.7%对35.6%)。SLD患者更可能未接受过治疗(82.3%对80.5%)、合并HBV感染(24.2%对13.6%)和肥胖(54.8%对17.1%)。62例患者中,59例(95%)实现了持续病毒学应答(SVR),但排除3例失访患者后,应答率为100%。在未合并SLD的HCV感染人群中,相应的SVR值分别为95%和98%。

结论

尽管HCV感染合并SLD患者的特征存在一些差异,但DAA治疗的有效性与HCV感染的普通人群中观察到的有效性无显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e5/11650810/d3dd0827131b/CEH-10-54506-g001.jpg

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