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直接作用抗病毒药物和C型肝炎的风险 肝外表现
Dahn Jeong1, Stanley Wong2,3, Mohammad Ehsanul Karim1,4
1School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
JAMA network open
|June 11, 2025
概括
对型肝炎病毒 (HCV) 感染的成功直接作用抗病毒治疗显著降低了主要肝外表现 (EHM) 的风险,包括病,中风和心脏事件. 早期的HCV治疗对于预防这些严重的健康并发症至关重要.
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) 感染与许多肝外表现 (EHM) 有关,这些表现会损害患者的生活质量.
- 直接作用抗病毒药物 (DAA) 为慢性HCV感染提供了高度有效的治疗方法.
研究的目的:
- 评估成功的DAA治疗与慢性HCV患者中EHM发生率之间的关联.
- 确定使用DAA实现持续病毒学反应 (SVR) 是否降低了特定EHM的风险.
主要方法:
- 基于人口的回顾性队列研究在加拿大不列颠哥伦比亚省,利用BC肝炎测试者队列 (超过130万人对HCV进行了测试).
- 包括22576名患有慢性HCV感染的个体,对DAA治疗 (达到SVR) 和未治疗组进行匹配,使用治疗重量的逆概率 (IPTW).
- 评估了慢性病 (CKD),末期病 (ESKD),2型糖尿病 (T2D),中风,主要心脏不良事件 (MACE) 和神经认知障碍 (NCD) 的发生率,平均随访时间为2.5年.
主要成果:
- 与没有治疗相比,成功的DAA治疗 (SVR) 与CKD/ESKD (acsHR,0.54),中风 (acsHR,0.66),MACE (acsHR,0.58) 和NCD (acsHR,0.52) 的风险明显降低.
- 在成功的DAA治疗和T2D风险之间没有发现显著的关联 (acsHR,1.04).
- 与未经治疗组相比,SVR组中CKD/ESKD,中风,MACE和NCD的发病率较低.
结论:
- 用DAA成功治疗HCV与降低几种重大EHM风险有关.
- 这些发现强调了早期HCV查和DAA治疗的重要性,以减轻EHM的风险,并改善患者的长期健康结果.
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