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直接抗病毒药物在丙型肝炎肝硬化患者中的应用进展

冉锡萍 蔡大川

引用本文:
Citation:

直接抗病毒药物在丙型肝炎肝硬化患者中的应用进展

DOI: 10.12449/JCH240828
基金项目: 

重庆市科卫联合医学科研重点项目 (2022ZDXM001);

重庆市首批公共卫生重点学科(专科) 

利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:冉锡萍负责查阅相关文献,分析/解释数据和起草文章;蔡大川负责对文章的知识性内容作批评性审阅与指导。
详细信息
    通信作者:

    蔡大川, cqmucdc@cqmu.edu.cn (ORCID: 0000-0003-3269-8549)

Advances in the application of direct-acting antivirals in patients with hepatitis C cirrhosis

Research funding: 

Chongqing Medical Scientific Research Key Project (Joint Project of Chongqing Health Commission and Science and Technology Bureau) (2022ZDXM001);

The First Batch of Key Disciplines on Public Health in Chongqing 

More Information
  • 摘要: 慢性丙型肝炎病毒感染可导致肝硬化的发生,肝硬化后出现肝细胞癌等并发症是慢性肝病患者的主要死亡原因。抗病毒治疗可以实现持续病毒学应答,改善肝炎、肝纤维化,进而延缓病程进展。直接抗病毒药物(DAA)在丙型肝炎肝硬化患者中的安全性和有效性已被证实,其是否能改善肝硬化患者疾病并发症和预后逐渐成为讨论和研究的热点。相关数据主要由国外学者报告,我国DAA上市较晚,尚缺乏中远期数据。本文回顾了最新的相关研究,对DAA在丙型肝炎肝硬化患者中的应用现状及其对临床预后的影响进行综述。

     

  • 表  1  近3年报道丙型肝炎代偿期肝硬化患者使用DAA达SVR后HCC发病风险的研究

    Table  1.   Summary of studies related to the risk of HCC in patients with compensated liver cirrhosis using DAA to achieve SVR in the last three years

    作者 年份 研究地点 研究类型 总人数(例) 随访时间 HCC(例) 发病(%) 发病率(%/人年)
    Kondili等35 2023 意大利 前瞻性 1 839 28.47个月 98 5.33
    Ciancio等36 2023 意大利 前瞻性 1 000 48个月 71 7.10 1.97
    Choi等37 2022 韩国 前瞻性 218 4.1年 17 7.80 2.89
    Semmler等38 2022 奥地利 前瞻性 475 41个月 22 4.60 1.45
    Sanduzzi-zamparelli等39 2022 西班牙 前瞻性 122 48个月 10 8.20 2.24
    Younossi等40 2022 美国 前瞻性 730 168周 37 5.07
    D’ambrosio等41 2022 意大利 前瞻性 480 51个月 32 6.67
    下载: 导出CSV

    表  2  近3年报道丙型肝炎失代偿期肝硬化患者使用DAA达SVR后HCC发病风险的研究

    Table  2.   Summary of studies related to the risk of HCC in patients with decompensated liver cirrhosis using DAA to achieve SVR in the last three years

    作者 年份 研究地点 研究类型 总人数(例) 随访时间 HCC(例) 发病(%) 发病率(%/人年)
    Kondili等35 2023 意大利 前瞻性 225 28.47个月 21 9.33
    Semmler等38 2022 奥地利 前瞻性 52 41个月 12 23.10 7.00
    Younossi等40 2022 美国 前瞻性 124 168周 21 16.94
    D’ambrosio等41 2022 意大利 前瞻性 89 51个月 14 15.73
    下载: 导出CSV
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  • 收稿日期:  2023-12-12
  • 录用日期:  2024-01-12
  • 出版日期:  2024-08-25
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