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接受直接抗病毒药物治疗的慢性丙型肝炎感染患者的性别差异。

Sex-related differences in patients with chronic hepatitis C infection treated with direct-acting antiviral drugs.

作者信息

Dobrowolska Krystyna, Zarębska-Michaluk Dorota, Pawłowska Malgorzata, Tudrujek-Zdunek Magdalena, Lorenc Beata, Berak Hanna, Janczewska Ewa, Mazur Włodzimierz, Janocha-Litwin Justyna, Klapaczyński Jakub, Sitko Marek, Dybowska Dorota, Parfieniuk-Kowerda Anna, Piekarska Anna, Jaroszewicz Jerzy, Flisiak Robert

机构信息

Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland.

Department of Infectious Diseases and Allergology, Jan Kochanowski University, Kielce 25-369, Poland.

出版信息

World J Hepatol. 2025 Jun 27;17(6):105899. doi: 10.4254/wjh.v17.i6.105899.

Abstract

BACKGROUND

Sex is one of the known factors influencing the risk of hepatitis C virus (HCV) infection and the natural course of the disease.

AIM

To evaluate sex-related differences in the characteristics and outcomes of direct-acting antiviral (DAA) treatment in HCV-infected patients.

METHODS

The study included consecutive 9457 women and 9529 men, treated with DAA for chronic HCV infection from July 2015 to the end of 2023 whose data were collected in the nationwide multicenter retrospective Epiter-2 project. Women were divided into pre-menopausal (15-44 years), menopausal (45-55 years) and post-menopausal (> 55 years) and compared with age-matched men.

RESULTS

Regardless of age, women had a significantly lower body mass index, prevalence of genotype 3 infection and proportion of cirrhosis compared to men. Psychiatric disorders (except depression), hepatitis B virus and human immunodeficiency virus co-infections, as well as alcohol and drug addiction, were significantly less common in women than in men in all age groups. The sustained virologic response was significantly higher in women compared to men in each age group and amounted to 98.4% and 96.6%, respectively ( < 0.001). Independent predictors of treatment failure in women were genotype 3 infection, cirrhosis and postmenopausal age. Mild adverse events were reported significantly more often by women, regardless of age with the highest percentage in the postmenopausal group.

CONCLUSION

DAA treatment is more effective in women than in men, regardless of age, but in postmenopausal women, the effectiveness is relatively the lowest.

摘要

背景

性别是影响丙型肝炎病毒(HCV)感染风险和疾病自然进程的已知因素之一。

目的

评估丙型肝炎病毒感染患者接受直接抗病毒药物(DAA)治疗的特征和结果中的性别差异。

方法

该研究纳入了2015年7月至2023年底期间接受DAA治疗慢性丙型肝炎感染的9457名女性和9529名男性,其数据收集于全国多中心回顾性Epiter-2项目。女性被分为绝经前(15 - 44岁)、围绝经期(45 - 55岁)和绝经后(>55岁),并与年龄匹配的男性进行比较。

结果

无论年龄如何,与男性相比,女性的体重指数、基因3型感染患病率和肝硬化比例均显著较低。在所有年龄组中,女性的精神障碍(抑郁症除外)、乙型肝炎病毒和人类免疫缺陷病毒合并感染以及酒精和药物成瘾的发生率均显著低于男性。各年龄组中女性的持续病毒学应答率均显著高于男性,分别为98.4%和96.6%(<0.001)。女性治疗失败的独立预测因素为基因3型感染、肝硬化和绝经后年龄。无论年龄大小,女性报告的轻度不良事件显著更多,绝经后组的比例最高。

结论

无论年龄如何,DAA治疗对女性比男性更有效,但绝经后女性的有效性相对最低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e230/12210159/cacf515549c3/wjh-17-6-105899-g001.jpg

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