在治疗C型肝炎后,肝硬度临床上显著下降:TRAP HepC全国消除计划的结果
Smári Freyr Kristjánsson1, Sigurdur Olafsson2, Magnús Gottfredsson1,3,4
1Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland.
Journal of clinical medicine
|June 13, 2025
概括
直接作用的抗病毒疗法在92%的慢性型肝炎治愈患者中显著降低了肝硬度.持续的肥胖和酒精使用与肝硬度增加有关,突出了持续风险因素管理的必要性.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 公共卫生 公共卫生
背景情况:
- 直接作用抗病毒疗法 (DAA) 为慢性型肝炎 (CHC) 提供高治愈率.
- 肝硬度测量 (LSM) 用于评估CHC患者的肝纤维化.
- 在冰岛,治疗作为预防C型肝炎 (TraP HepC) 倡议监测CHC患者.
研究的目的:
- 为了评估CHC的DAA治疗后肝硬度的变化.
- 为了确定与肝纤维化进展或回归相关的风险因素.
主要方法:
- 对基线LSM>9.5kPa的CHC患者的回顾性分析.
- 后续的LSM测量,风险因素评估 (BMI,酒精) 和生物化学测试.
- 基线和随访肝硬度值的比较.
主要成果:
- 治疗后肝硬度的中位数从17.2 kPa降至7.3 kPa (p < 0.01).
- 80%的基线肝硬化 (LSM>12.5kPa) 患者回归到非肝硬化水平.
- 在一组患者中,高BMI和每日饮酒与肝硬度增加相关.
结论:
- 在92%的通过DAA治愈的CHC患者中,观察到肝硬度的显著回归.
- 持续的危险因素,如肥胖和滥用酒精,即使在病毒治愈后,也与肝硬度升高有关.
- 综合管理风险因素对于CHC幸存者的长期肝脏健康至关重要.
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