在突尼斯未经治疗的HBV患者中,与进展性肝病相关的因素
Sana Rouis1, Soumaya Mrabet2, Mohamed Ferjaoui1
1Department of Infectious Diseases, Faculty of Medicine of Sousse, University of Sousse, Ibn El Jazzar University Hospital, Kairouan, Tunisia.
F1000Research
|September 15, 2025
概括
同病症和阿氨酸转移酶 (ALT) 变化预测慢性乙型肝炎病毒 (HBV) 患者在不确定阶段的肝纤维化进展. 这些发现支持最新的世卫组织指南,扩大了B型肝炎的治疗标准.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 内部医学 内部医学
背景情况:
- 慢性乙型肝炎病毒 (HBV) 感染管理传统上排除在外的患者.
- 一个不确定的阶段.
- 由升高的HBVDNA,正常的ALT和最小的纤维化定义.
- 最近的世卫组织指导方针 (2024) 扩大了治疗标准,使治疗标准变得更加完整.
- 一个不确定的阶段.
- 这个概念已经过时了.
研究的目的:
- 为了确定与肝纤维化进展相关的因素,慢性HBV患者在肝脏纤维化进展.
- 一个不确定的阶段.
- 在指南变更之前.
- 提供支持B型肝炎最新国际治疗建议的证据.
主要方法:
- 在97名未经治疗的HBsAg阳性患者的逆向纵向队列研究中,HBV DNA>2,000 IU/mL,ALT正常,F0-F1纤维化.
- 从2008年1月到2022年1月在突尼斯的Farhat Hached大学医院收集的数据.
- 单变量和逻辑回归分析以确定纤维化进展的预测因素.
主要成果:
- 16.5%的患者经历了纤维化进展,平均时间为70.9个月.
- 与纤维化进展的显著关联包括并发症,初始病毒载量高,肝酶升高和随访病毒载量增加.
- 多变量分析确定了并发症和ALT水平的变化作为独立预测因素.
结论:
- 并发症和阿氨酸转移酶 (ALT) 水平波动是以前被归类为不确定的慢性HBV患者肝纤维化进展的关键预测因素.
- 这些发现符合并支持2024年世卫组织关于更广泛的乙型肝炎治疗资格的建议.
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