Clinical, virologic, histologic, and biochemical outcomes after successful HCV therapy: a 5-year follow-up of 150 patients.
Clinical, virologic, histologic, and biochemical outcomes after successful HCV therapy: a 5-year follow-up of 150 patients.
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DOI：
10.1002/hep.22694
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发表时间：
2009-03
期刊：
影响因子：
13.5
通讯作者：
Di Bisceglie, Adrian M.
中科院分区：
文献类型：
--
作者：
George, Sarah L.;Bacon, Bruce R.;Brunt, Elizabeth M.;Mihindukulasuriya, Kusal L.;Hoffmann, Joyce;Di Bisceglie, Adrian M.
150例慢性丙型肝炎治疗后持续病毒学应答（SVR）的患者参加了一项长期临床随访研究;患者随访5年，以获得肝脏相关结局和生化或病毒学复发的证据。治疗前活检时纤维化为2期或以上的患者在随访第4年后接受长期随访活检。128例患者（85%）随访至第4年，60例患者（40%）获得长期随访活检。49例患者进行了配对的治疗前和长期随访活检盲重新评分。其中40例（82%）的纤维化评分降低，45例（92%）的联合炎症评分降低。10名患者（20%）在长期随访活检中肝脏正常或接近正常。2例治疗前肝硬化患者发生肝细胞癌（HCC），1例死亡。所有其他治疗前肝硬化或晚期纤维化的患者在长期随访活检中纤维化评分均有所改善。没有病人有病毒学复发的确切证据。3例患者丙氨酸氨基转移酶（ALT）水平持续升高;其中2例新发肝病。总之，在该队列的150例SVR患者中，随访5年，大多数患者的结局良好。血清病毒学复发没有看到，但两名患者治疗前肝硬化发展为肝癌，一人死亡。在对49例配对的治疗前和长期随访活检进行盲法再评分时，82%的患者纤维化评分改善，92%的患者至少改善了一种炎症。少数患者在长期随访活检中肝组织正常或接近正常。肝硬化预治疗患者在SVR后发生HCC的风险较低，但却是真实的。
One hundred and fifty patients with sustained virologic response (SVR) after treatment of chronic hepatitis C were enrolled in a long-term clinical follow-up study; patients were followed for 5 years for liver-related outcomes and evidence of biochemical or virologic relapse. Patients with stage two or greater fibrosis on pre-treatment biopsy were invited to undergo a long-term follow-up biopsy after their 4th year of follow-up. One hundred twenty-eight patients (85%) were followed through their 4th year and long-term follow-up biopsies were obtained from 60 patients (40%). Forty-nine patients had paired pre-treatment and long-term follow-up biopsies blindly rescored. Forty of these (82%) had a decrease in fibrosis score and forty-five (92%) had a decrease in combined inflammation score. Ten patients (20%) had normal or nearly normal livers on long-term follow-up biopsy. Two patients with pre-treatment cirrhosis developed hepatocellular carcinoma (HCC) and one died. All the other patients with pre-treatment cirrhosis or advanced fibrosis had improved fibrosis scores on long-term follow-up biopsy. No patient had conclusive evidence of virologic relapse. Three patients had persistently elevated alanine aminotransferase (ALT) levels; two of these had new liver disease. In conclusion, in this cohort of 150 patients with SVR followed for five years the majority of patients had good outcomes. Serum virologic relapse was not seen but two patients with pre-treatment cirrhosis developed HCC and one died. In blind rescoring of forty-nine paired pre-treatment and long-term follow-up biopsies 82% improved fibrosis scores and 92% improved at least one component of inflammation. A minority of patients had normal or nearly normal liver tissue on long-term follow-up biopsy. Patients with cirrhosis pre-treatment are at a low but real risk of HCC after SVR.
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影响因子：
13.5
作者：
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通讯作者：
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影响因子：
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作者：
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