The natural history of hepatitis C with severe hepatic fibrosis
The natural history of hepatitis C with severe hepatic fibrosis
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DOI：
10.1016/j.jhep.2007.02.010
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发表时间：
2007-07-01
影响因子：
25.7
通讯作者：
Irving, William L.
中科院分区：
文献类型：
--
作者：
Lawson, Adam;Hagan, Simone;Irving, William L.
背景/目标：为了检查继发于HCV感染的严重纤维化患者的发病率和死亡率，在三级referreration.Methods：150例HCV感染患者被确定为特伦特HCV研究与2002年之前采取的肝活检显示严重纤维化（Ishak阶段>= 4）。随访数据来自数据库和医院记录。结果：中位随访时间为51个月。在131例既往无失代偿史的患者中，33例（25%）在中位间隔42个月后死亡（n = 25）或接受移植（n = 8）。在1年、3年和5年时，不进行肝移植的生存概率分别为97%、88%和78%。在中位间隔41个月后，33例（25%）被诊断为肝细胞癌和/或失代偿。在多变量分析中，联合抗病毒治疗与生存率改善相关。预后不受索引活检的Ishak分期的影响。19例既往失代偿患者的预后较差; 17例（89%）死亡（n = 15）或移植（n = 2）。结论：本研究表明，丙型肝炎继发严重肝纤维化（Ishak分期>= 4）与预后不良相关，联合抗病毒治疗可能会改善。(c)2007年欧洲肝脏研究协会。Elsevier B. V.出版，保留所有权利。
Background/Aims: To examine the morbidity and mortality of patients with severe fibrosis secondary to HCV infection, within a population unbiased by tertiary referral.Methods: One hundred and fifty HCV infected patients were identified from the Trent HCV study with a liver biopsy taken before 2002 demonstrating severe fibrosis (Ishak stage >= 4). Follow-up data were extracted from the database and hospital records.Results: Median follow-up was 51 months. Of the 131 patients with no prior history of decompensation, 33 (25%) died (n = 25) or were transplanted (n = 8), after a median interval of 42 months. The probability of survival without liver transplantation was 97%, 88%, and 78% at 1, 3, and 5 years, respectively. Hepatocellular carcinoma and/or decompensation was diagnosed in 33 (25%), after a median interval of 41 months. In multivariate analysis, combination antiviral therapy was associated with improved survival. Prognosis was not affected by the Ishak stage at index biopsy. There was a worse prognosis for the 19 patients with previous decompensation; 17 (89%) having either died (n = 15) or been transplanted (n = 2).Conclusions: This study demonstrates that severe liver fibrosis (Ishak stage >= 4) secondary to hepatitis C is associated with a poor prognosis, that may be improved following combination antiviral treatment. (c) 2007 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.