A comparison of fibrosis progression in chronic liver diseases
A comparison of fibrosis progression in chronic liver diseases
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DOI：
10.1016/s0168-8278(02)00413-0
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发表时间：
2003-03-01
影响因子：
25.7
通讯作者：
Bedossa, P
中科院分区：
文献类型：
--
作者：
Poynard, T;Mathurin, P;Bedossa, P
方法：对4852例慢性丙型肝炎患者(慢性丙型肝炎2313例，人类免疫缺陷病毒-丙型肝炎病毒混合感染180例，乙型肝炎777例)，酒精性肝病701例，原发性胆汁性肝硬变406例，遗传性血色素沉着症(GH[n=383])、自身免疫性肝炎(AIH[n=57])和三角洲肝炎(n=35)。结果：肝纤维化进展速度有非常显著的差异，最快的是HIV-丙型肝炎病毒混合感染(52岁时50%的肝硬变百分位数)，最慢的是PBC(81岁时50%的肝硬变百分位数)。随着年龄的增长，纤维化进程加快。与男性相比，女性的丙型肝炎病毒、乙肝病毒、生长激素和PBC的纤维化进展较慢。相反，在ALD患者中，女性的纤维化进展更快。结论：在慢性肝病的主要病因之间，以及年龄和性别之间，纤维化进展的速度明显不同。艾滋病毒-丙型肝炎病毒混合感染的患者纤维化进展的风险特别高。(C)2002年欧洲肝脏研究协会。爱思唯尔科学公司出版。版权所有。
Background/Aims: No study has compared the liver fibrosis progression rates among chronic liver diseases and the risk factors in order to better organize screening strategies.Methods: A total of 4852 patients were retrospectively studied (chronic hepatitis C (HCV) [n = 2313], human immunodeficiency virus (HIV)-HCV co-infection (HIV-HCV [n = 180]), hepatitis B (HBV [n = 777]), alcoholic liver disease (ALD [n = 701]), primary biliary cirrhosis (PBC [n = 406]), genetic hemochromatosis (GH [n = 383]) autoimmune hepatitis (AIH [n = 57]) and delta hepatitis (n = 35). The fibrosis progression rates were estimated from birth and from the date of exposure, when known, to the first biopsy.Results: There were highly significant differences in the rates of fibrosis progression, the most rapid being HIV-HCV co-infection (50% cirrhosis percentile at 52 years of age) and the slowest being PBC (50% cirrhosis percentile at 81 years). There was an acceleration of fibrosis progression with aging. Fibrosis progression was slower in females compared with males for HCV, HBV, GH, and PBC. In contrast, in ALD, the fibrosis progression was more rapid in females.Conclusions: Rates of fibrosis progression differ markedly between the predominant causes of chronic liver disease, and according to age and gender. Patients with HIV-HCV co-infection are at particularly high risk of fibrosis progression. (C) 2002 European Association for the Study of the Liver. Published by Elsevier Science B.V. All rights reserved.