Clinical impact of normal alanine aminotransferase on direct‐acting antiviral outcome in patients with chronic hepatitis C virus infection
Clinical impact of normal alanine aminotransferase on direct‐acting antiviral outcome in patients with chronic hepatitis C virus infection
复制标题
正常丙氨酸氨基转移酶对慢性丙型肝炎病毒感染患者直接作用抗病毒结果的临床影响
作者：
Joshita Satoru;Sugiura Ayumi;Umemura Takeji;Yamazaki Tomoo;Fujimori Naoyuki;Matsumoto Akihiro;Usami Yoko;Tanaka Eiji
背景与目的本研究旨在阐明丙氨酸氨基转移酶（CNALT）正常和ALT升高的丙型肝炎病毒（HCV）携带者的临床表现（非CNALT）在直接作用抗病毒药物（DAA）下。（427名男性，中位年龄：69岁），他们接受了DAA，以比较CNALT（男性ALT ≤33 U/L，女性ALT ≤25 U/L;结果CNALT患者的血小板计数（PLT）高于非CNALT患者（n= 374）和非CNALT患者（n= 628）。（170 000 vs 146 000/μL，P< 0.0001）和白蛋白（4.1 vs4.1 g/dL，P= 0.0006），但AST（25 vs 51 U/L，P< 0.0001）、甲胎蛋白（3.2 vs5.4 ng/mL，P< 0.0001）和肝纤维化标志物评分（均P < 0.0001）较低。CNALT组和非CNALT组的持续病毒学应答率相当（97.8vs95.3%，P = 0.106）。CNALT和非CNALT组之间DAA治疗后肝细胞癌（HCC）的累积发生率相当（P= 0.117，对数秩检验）。在有HCC病史的CNALT患者中，PLT ≥ 150000/μL是HCC复发的独立危险因素（P= 0.019）。在无HCC病史的non-CNALT患者中，男性（P= 0.021）和白蛋白<4.0 g/dL（P= 0.007）是HCC发生的独立危险因素，而PLT < 150 000/μL（P= 0.081）是HCC发生的边缘危险因素。CNALT和PLT状态的组合可能是有用的肝癌发生或复发监测的标志物。
Background and AimsThis study aimed to clarify the clinical picture of hepatitis C virus (HCV) carriers with normal alanine aminotransferase (CNALT) and those with ALT elevation (non‐CNALT) under direct‐acting antivirals (DAAs).MethodsWe enrolled 1002 patients with HCV (427 men, median age: 69 years) who had received DAAs for comparisons between CNALT (ALT ≤33 U/L in males and ≤25 U/L in females;n= 374) and non‐CNALT (n= 628) groups.ResultsCNALT patients displayed a higher platelet count (PLT) (170 000vs146 000/μL,P< 0.0001) and albumin (4.1vs4.1 g/dL,P= 0.0006) but lower AST (25vs51 U/L,P< 0.0001), alpha fetoprotein (3.2vs5.4 ng/mL,P< 0.0001), and liver fibrosis marker scores (allP< 0.0001). The sustained virologic response rate was comparable between the CNALT and non‐CNALT groups (97.8vs95.3%,P= 0.106). The cumulative incidence of hepatocellular carcinoma (HCC) after DAA treatment was comparable between the CNALT and non‐CNALT groups (P= 0.117, log‐rank test). In CNALT patients with HCC history, PLT ≥150 000/μL was an independent risk factor of HCC recurrence (P= 0.019). In non‐CNALT patients without HCC history, male gender (P= 0.021) and albumin <4.0 g/dL (P= 0.007) were independent risk factors, while PLT < 150 000/μL (P= 0.081) was a marginal risk factor of HCC occurrence.ConclusionCNALT patients displayed a milder degree of liver fibrosis. Combinations of CNALT and PLT status might be useful as markers for HCC occurrence or recurrence surveillance.
影响因子：
82.9
作者：
通讯作者：
--
直接抗病毒药物消灭丙型肝炎病毒对慢性丙型肝炎病毒感染者血脂水平及“宁根码头”体检类别的临床影响
DOI：
--
发表时间：
2020
期刊：
Ningen Dock International
影响因子：
--
作者：
Joshita Satoru;Sugiura Ayumi;Yamazaki Tomoo;et al.
通讯作者：
et al.
影响因子：
3.4
作者：
Chida T;Kawata K;Ohta K;Matsunaga E;Ito J;Shimoyama S;Yamazaki S;Noritake H;Suzuki T;Suda T;Kobayashi Y
通讯作者：
Kobayashi Y