Hepatology:DAA治疗获得非晚期肝病患者获得SVR后,患者的死亡可得到改善

2018-09-27 MedSci MedSci原创

DAA治疗获得SVR后,非晚期HCV肝病患者的死亡可得到改善。

HCV 患者采用DAA治疗,获得持续病毒学应答(SVR)后,对非晚期肝病患者死亡率的影响,目前并不清楚。近日,发表在Hepatology杂志上的一项研究表明,DAA治疗获得SVR后,非晚期HCV肝病患者的死亡可得到改善。

本研究为观察性队列分析,共纳入103346例基因1,2,3型HCV患者,这些患者中均为非晚期肝病HCV患者,即 FIB-4 ≤3.25,无肝硬化、肝失代偿、肝细胞癌或肝移植病史。

在40664例接受无干扰素的DAA治疗方案的患者中,39,374 (96.8%) 获得SVR 和 1,290  (3.2%) 患者未获得SVR,62,682例患者未接受治疗。相比,未获得SVR(2.84 /100 人-年) 或未接受治疗(3.84 /100人年-)的患者,获得SVR的HCV患者的死亡率显著降低,为 1.18 /100 人-年。相比未获得SVR的患者,获得SVR且FIB<1.45和处于1.45-3.25的患者,其死亡率分别减少46.0% (P = 0.036)和 63.2% (P < 0.001);相比未治疗的患者,获得SVR且FIB<1.45和处于1.45-3.25的患者,其死亡率分别减少66.7% (P < 0.001) 和 70.6% (P < 0.001)。在多变量Cox比例危险模型中,控制基线人口统计学、临床特征和并发症,相比未获得SVR的患者,SVR与死亡风险减少相关 (危险比, 0.44; 95% 置信区间, 0.32-0.59; P < 0.001) ;相比未治疗的患者,SVR与死亡风险减少相关(危险比, 0.32; 95%置信区间l, 0.29-0.36; P < 0.001)。

原始出处

Backus LI, Belperio PS, Shahoumian TA, et al. Direct-acting antiviral sustained virologic response: Impact on mortality in patients without advanced liver disease. Hepatology, 2018, 68(3), 827-838.

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    2018-09-29 qingting
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    2018-09-29 w363522450
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    2018-09-29 gwc384

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