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在C型肝炎感染者,治愈者和从未感染的对照者中比较不良结果的风险
Varun Saxena1,2, Weilu Wu3, Sreepriya Balasubramanian1
1Gastroenterology and Hepatology, Kaiser Permanente, Oakland, California.
Gastro hep advances
|September 16, 2024
概括
治疗C型肝炎病毒 (HCV) 显著减少了不良结果,但与未感染个体相比,并不总能使风险正常化. 在HCV治愈后的低风险组可能会避免持续的专科护理.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 型肝炎病毒 (HCV) 治愈与减少不良健康结果有关.
- 然而,在治愈的HCV患者和从未感染过的人之间,没有直接比较结果.
- 这种数据缺口影响了关于治疗后专科后续治疗的决策.
研究的目的:
- 为了比较从未感染过HCV的人与从未感染过HCV的人之间的健康状况不佳的风险.
- 确定治愈的HCV患者的低风险子组,这些患者可能不需要持续的专业护理.
- 根据临床指导方针,制定治疗后的后续战略.
主要方法:
- 一项回顾性队列研究使用了2002-2019年的数据进行.
- 分析了三个队列:慢性HCV,HCV治愈和匹配的HCV阴性对照.
- 结局包括肝硬化,不补偿性肝硬化,肝细胞癌 (HCC) 和全因死亡率.
主要成果:
- 与慢性HCV相比,HCV治愈显著降低了肝硬化,5年累计发病率,失补偿性肝硬化,HCC和全因死亡率.
- 然而,在HCV治愈的个体中,这些结果的风险在数量上仍然高于从未感染过的对照组.
- 一个低风险的HCV治愈个体的子组显示出数量上与对照组相似的结果.
结论:
- 虽然治疗HCV提供了巨大的好处,但它可能无法完全恢复一般人群的风险.
- 分层治愈的个体来确定一个低风险组是可行的.
- 这种分层可以使护理减缓,包括从专科诊所出院和停止对特定患者的HCC监测.
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