Chronic hepatitis C virus (HCV) increases the risk of chronic kidney disease (CKD) while effective HCV treatment decreases the incidence of CKD.
Chronic hepatitis C virus (HCV) increases the risk of chronic kidney disease (CKD) while effective HCV treatment decreases the incidence of CKD.
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DOI：
10.1002/hep.29505
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发表时间：
2018-03
期刊：
影响因子：
--
通讯作者：
Nelson DR
中科院分区：
文献类型：
--
作者：
Park H;Chen C;Wang W;Henry L;Cook RL;Nelson DR
我们评估了慢性丙型肝炎病毒感染患者患慢性肾脏疾病的风险，以及接受丙型肝炎病毒治疗后慢性肾脏疾病发病率的降低。我们还评估了慢性丙型肝炎患者发生膜增生性肾小球肾炎(MPGN)和冷球蛋白血症的风险。对美国Truven Health MarketScan数据库(2008-2015)进行了回顾性队列分析。在一组56,448名丙型肝炎病毒感染患者和169,344名倾向评分(1：3)匹配的非丙型肝炎患者中，我们研究了丙型肝炎病毒感染与慢性肾脏病发病率的关系。在55,818名丙型肝炎患者中，6.6%(n=3666)、6.3%(n=3534)和8.3%(n=4628)的患者分别接受了基于干扰素的双重、三重或全口服直接作用抗病毒药物治疗，而79%的患者没有接受任何丙型肝炎病毒治疗。用COX比例风险模型比较丙型肝炎患者与非丙型肝炎患者和治疗患者与未治疗丙型肝炎患者发生慢性肾脏病的风险。在多变量时变Cox回归模型中，与非丙型肝炎患者相比，感染丙型肝炎病毒的患者患慢性肾脏病的风险增加27%(危险比[HR]，1.27；95%可信区间[CI]，1.18-1.37)。在丙型肝炎患者中，接受最低有效的丙型肝炎病毒双重、三联或全口服治疗的患者发生CKD的风险降低30%(HR，0.70；95%CI，0.55-0.88)。此外，与非丙型肝炎患者相比，感染丙型肝炎病毒的患者患MPGN(HR，2.23；95%CI，1.84-2.71)和冷球蛋白血症(HR，16.91；95%CI，12.00-23.81)的风险分别增加一倍和近17倍。结论：在美国，丙型肝炎病毒感染者患慢性肾脏病、MPGN和冷球蛋白血症的风险更大。丙型肝炎病毒感染的最低有效治疗可以防止CKD的发展，尽管这种相关性在全口服治疗中并不显著。(《肝病》2018；67：492-504)。
We assessed the risk of chronic kidney disease (CKD) in chronic hepatitis C virus (HCV)‐infected patients and the incidence reduction of CKD after receipt of HCV treatment. We also evaluated the risk of membranoproliferative glomerulonephritis (MPGN) and cryoglobulinemia in chronic HCV patients. A retrospective cohort analysis of the Truven Health MarketScan Database (2008‐2015) in the United States was conducted. In a cohort of 56,448 HCV‐infected patients and 169,344 propensity score (1:3)–matched non‐HCV patients, we examined the association of HCV infection with the incidence of CKD. Of 55,818 HCV patients, 6.6 % (n = 3666), 6.3% (n = 3534), and 8.3% (n = 4628) patients received either interferon‐based dual, triple, or all‐oral direct acting antiviral agent therapy, respectively, whereas 79% of patients did not receive any HCV treatment. Cox proportional hazards models were used to compare the risk of developing CKD in HCV patients compared with non‐HCV patients and treated patients compared with untreated HCV patients. In a multivariate time‐varying Cox regression model, HCV‐infected patients had a 27% increased risk of CKD compared with non‐HCV patients (hazard ratio [HR], 1.27; 95% confidence interval [CI], 1.18‐1.37). Among HCV patients, individuals who received the minimally effective HCV treatment for dual, triple, or all‐oral therapy had a 30% decreased risk of developing CKD (HR, 0.70; 95% CI, 0.55‐0.88). In addition, HCV‐infected patients experienced a twofold and a nearly 17‐fold higher risk of MPGN (HR, 2.23; 95% CI, 1.84‐2.71) and cryoglobulinemia (HR, 16.91; 95% CI, 12.00‐23.81) respectively, compared with non‐HCV patients. Conclusion: HCV‐infected individuals in the United States are at greater risk of developing CKD, MPGN, and cryoglobulinemia. Minimally effective treatment of HCV infection can prevent the development of CKD, although the association was not significant for all‐oral therapy. (Hepatology 2018;67:492‐504).
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影响因子：
39.2
作者：
Denniston MM;Jiles RB;Drobeniuc J;Klevens RM;Ward JW;McQuillan GM;Holmberg SD
通讯作者：
Holmberg SD
影响因子：
13.5
作者：
El-Serag, HB;Hampel, H;Rabeneck, L
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Rabeneck, L
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19.6
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Charles, Edgar D.;Dustin, Lynn B.
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Dustin, Lynn B.
影响因子：
158.5
作者：
JOHNSON, RJ;GRETCH, DR;WILLSON, R
通讯作者：
WILLSON, R
影响因子：
13.5
作者：
Hsu, Yao-Chun;Lin, Jaw-Town;Wu, Chun-Ying
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Wu, Chun-Ying