Increasing prevalence of HCC and cirrhosis in patients with chronic hepatitis C virus infection.
Increasing prevalence of HCC and cirrhosis in patients with chronic hepatitis C virus infection.
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DOI：
10.1053/j.gastro.2010.12.032
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发表时间：
2011-04
期刊：
影响因子：
29.4
通讯作者：
El-Serag HB
中科院分区：
文献类型：
--
作者：
Kanwal F;Hoang T;Kramer JR;Asch SM;Goetz MB;Zeringue A;Richardson P;El-Serag HB
丙型肝炎病毒（HCV）感染患者有发生其他肝脏疾病的风险，这些疾病的治疗费用高，发病率高，尽管这些疾病的实际患病率尚不清楚。我们研究了肝硬化及其相关并发症的流行趋势，如肝失代偿和肝细胞癌（HCC）。我们计算了1996年至2006年间诊断为HCV的全国退伍军人样本中肝硬化、失代偿性肝硬化和HCC的年患病率。在给定日历年中至少有1次医生就诊的HCV患者被纳入该年的患病率分析。我们使用直接标准化来调整肝硬化及相关并发症的患病率，以适应年龄、性别和临床特征的变化。在该队列中，HCV患者人数从1996年的17261人增加到2006年的106242人。肝硬化的患病率从1996年的9%上升到2006年的18.5%。同样，失代偿性肝硬化患者的患病率增加了一倍，从1996年的5%增加到2006年的11%，而HCC的患病率增加了大约20倍（从1996年的0.07%增加到2006年的1.3%）。调整后，肝硬化（及其并发症）患病率的时间趋势低于粗趋势，但仍显著增加。在过去10年中，丙型肝炎感染患者中肝硬化和HCC的患病率显著增加，并且可能进一步增加。HCV患者的老龄化队列可以部分解释我们的发现。临床医生和卫生保健系统应制定策略，为这一高危人群提供及时有效的护理。
Patients with hepatitis C virus (HCV) infection are at risk for developing additional liver disorders that are costly to treat and have high rates of morbidity, although the actual prevalence of these diseases is not known. We examined time trends in the prevalence of cirrhosis and its related complications, such as hepatic decompensation and hepatocellular cancer (HCC). We calculated the annual prevalence of cirrhosis, decompensated cirrhosis, and HCC in a national sample of veterans diagnosed with HCV between 1996 and 2006. Patients with HCV who had at least 1 physician visit in a given calendar year were included in the analysis of prevalence for that year. We used direct standardization to adjust the prevalence of cirrhosis and related complications for increasing age of the cohort, as well as sex and changes in clinical characteristics. In this cohort, the number of individuals with HCV increased from 17,261 in 1996 to 106,242 in 2006. The prevalence of cirrhosis increased from 9% in 1996 to 18.5% in 2006. Similarly, the prevalence of patients with decompensated cirrhosis doubled, from 5% in 1996 to 11% in 2006, whereas the prevalence of HCC increased approximately 20-fold (0.07% in 1996 to 1.3% in 2006). After adjustment, the time trend in the prevalence of cirrhosis (and its complications) was lower than the crude trend, although it still increased significantly. The prevalence of cirrhosis and HCC in HCV-infected patients has increased significantly over the past 10 years, and could increase further. An aging cohort of HCV patients could partly explain our findings. Clinicians and healthcare systems should develop strategies to provide timely and effective care to this high-risk population of patients.
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13.5
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Thomas, DL
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Thomas, DL
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