随着时间的推移,肝细胞癌的风险随着C型肝炎病毒根除后的时间累积而降低
Philip Vutien1,2, Nicole J Kim1,2, Andrew M Moon3,4
1Division of Gastroenterology and Hepatology, University of Washington, Seattle, Washington, USA.
Alimentary pharmacology & therapeutics
|November 13, 2023
概括
在C型肝炎病毒 (HCV) 根除后,肝细胞癌 (HCC) 风险随着时间的推移而降低,特别是在肝硬化患者中. 建议在持续病毒学反应 (SVR) 后的几年内继续进行监测.
科学领域:
- 肝病学和病毒性胃肠道学
- 瘤学和癌症研究研究
- 公共卫生和流行病学
背景情况:
- 在成功根除型肝炎病毒 (HCV) 后,肝细胞癌 (HCC) 的长期风险仍然不确定.
- 了解HCC风险持续病毒反应后 (SVR) 的时间趋势对于患者管理至关重要.
研究的目的:
- 调查持续病毒学反应 (SVR) 持续时间是否与HCC风险降低有关.
- 分析HCV根除后的时间与HCC发病率之间的关联.
主要方法:
- 对75,965名退伍军人事务患者进行了回顾性队列研究,这些患者在2018年1月之前实现了SVR.
- 在SVR后12个月内分析HCC发病率,并根据多种临床和人口因素进行调整.
- 多变量考克斯比例危险回归用于评估SVR和HCC风险发生时间之间的关系.
主要成果:
- 在肝硬化患者中,HCC发病率随着SVR发生时间的延长而逐渐降低,长达6年 (例如,>4-6年与1-2年相比:aHR 0.61).
- 在SVR后6年,肝硬化患者的HCC风险似乎停滞不前 (aHR为0.70).
- 在没有肝硬化的患者中,没有观察到SVR和HCC风险发生的时间之间的显著关联.
结论:
- 患有肝硬化的HCV感染患者获得SVR,经历治疗后长达6年的HCC风险下降.
- 然而,风险仍然很高,这强调了需要持续实施HCC监测策略的需要.
- 自从SVR发生以来的时间是完善HCC风险预测模型和指导治愈HCV患者监测的重要因素.
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