在怀孕期间HCV对美沙剂量的影响
Sarah Boudova1, Neel S Iyer1, Danielle M Tholey2
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Journal of viral hepatitis
|August 4, 2025
概括
这项研究发现,肝炎C病毒 (HCV) 感染不需要改变孕妇阿片类药物使用障碍 (OUD) 患者的美沙剂量. 肝纤维化是罕见的,这表明大多数HCV阳性个体在怀孕期间接受标准甲治疗是安全的.
科学领域:
- 产科和妇科 产科和妇科
- 肝病学 肝病学是一种肝病学.
- 成 药物 药物 药物 药物
背景情况:
- 怀孕增加了对阿片类药物使用障碍 (OUD) 治疗的动机.
- 怀孕和C型肝炎病毒 (HCV) 感染可以改变肝脏药物代谢.
- 了解HCV对怀孕期间甲剂量的影响对于有效的OUD管理至关重要.
研究的目的:
- 检查怀孕期间HCV感染对甲剂量要求的影响.
- 为了评估肝纤维化的发病率在怀孕的OUD患者与HCV.
- 为了确定HCV状态是否会影响孕妇甲剂量稳定性.
主要方法:
- 对孕妇使用OUD开始服用美沙的怀孕患者的回顾性图表审查 (1/2020-6/2022).
- 分析包括HCV查,RNA测试,病毒载量和纤维化-4 (Fib4) 评分.
- 统计方法:t测试,奇二次测试,费舍尔精确测试和回归分析.
主要成果:
- 在191例怀孕中,59%为HCV抗体阳性,61.1%的受试者为HCVRNA阳性.
- 型冠状病毒RNA阳性个体的Fib4分数较高 (p=0.022),但显著的肝纤维化 (Fib4>1.45) 是罕见的 (n=5).
- 在HCVRNA阳性,病毒载量或Fib4得分和稳定的甲剂量 (p > 0.105) 之间没有发现相关性.
结论:
- 甲剂量的HCV特异性改变对于OUD的孕妇患者可能是不必要的.
- 在这个人群中,显著的纤维性肝损伤并不常见.
- 对于患有晚期纤维化症的孕妇患者,建议进行进一步的研究.
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