在人类免疫缺陷病毒感染者中根除丙型肝炎病毒:我们现在在哪里?

IF 2.5 Q2 GASTROENTEROLOGY & HEPATOLOGY
A. Spera, Pasquale Pagliano, Valeria Conti
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引用次数: 0

摘要

世界卫生组织称,在全球约 3770 万艾滋病毒感染者中,仍有 230 万患者同时感染丙型肝炎病毒(HCV)和人类免疫缺陷病毒(HIV)。与艾滋病毒阴性感染者相比,艾滋病毒感染者的丙型肝炎病毒感染率是后者的六倍;注射毒品者和男男性行为者的丙型肝炎病毒感染率更高:在这种情况下,艾滋病毒感染会增加通过性接触传播丙型肝炎病毒的风险。这些患者的慢性肝炎发病率很高,如果不及时治疗,会发展为终末期肝病和肝细胞癌(HCC)。 艾滋病毒感染会增加母婴垂直传播 HCV 的风险。目前还没有针对这两种感染的疫苗。艾滋病病毒和丙型肝炎病毒感染之间存在相互作用。目前,HCV 的治疗以直接作用抗病毒药物(DAAs)为主,HCV 治疗在限制肝病进展、降低单发和合并感染者发生 HCC 的风险方面发挥着关键作用,尤其是在肝纤维化的早期阶段使用,可降低肝病死亡率和发病率。由于在根除 HCV 后的艾滋病毒感染者中观察到第 12 周的持续病毒学应答率,AASLD 修订了其简化的 HCV 治疗算法,将艾滋病毒感染者也纳入其中。根除 HCV 可导致血脂异常,因为 HCV 会促使血清脂质谱发生变化,并可能影响脂质代谢。除了这些对血脂谱的明显不利影响外,DAA 对 HCV/HIV 患者的疗效还需要考虑到其通过改善肝功能对糖代谢的影响。本社论旨在介绍艾滋病毒/艾滋病感染者的 HCV 治疗进展。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hepatitis C virus eradication in people living with human immunodeficiency virus: Where are we now?
Hepatitis C virus (HCV)/human immunodeficiency virus (HIV) co-infection still involves 2.3 million patients worldwide of the estimated 37.7 million living with HIV, according to World Health Organization. People living with HIV (PLWH) are six times greater affected by HCV, compared to HIV negative ones; the greater prevalence is encountered among people who inject drugs and men who have sex with men: the risk of HCV transmission through sexual contact in this setting can be increased by HIV infection. These patients experience a high rate of chronic hepatitis, which if left untreated progresses to end-stage liver disease and hepatocellular carcinoma (HCC) HIV infection increases the risk of mother to child vertical transmission of HCV. No vaccination against both infections is still available. There is an interplay between HIV and HCV infections. Treatment of HCV is nowadays based on direct acting antivirals (DAAs), HCV treatment plays a key role in limiting the progression of liver disease and reducing the risk of HCC development in mono- and coinfected individuals, especially when used at an early stage of fibrosis, reducing liver disease mortality and morbidity. Since the sustained virological response at week 12 rates were observed in PLWH after HCV eradication, the AASLD has revised its simplified HCV treatment algorithm to also include individuals living with HIV. HCV eradication can determine dyslipidemia, since HCV promotes changes in serum lipid profiles and may influence lipid metabolism. In addition to these apparent detrimental effects on the lipid profile, the efficacy of DAA in HCV/HIV patients needs to be considered in light of its effects on glucose metabolism mediated by improvements in liver function. The aim of the present editorial is to describe the advancement in HCV treatment among PLWH.
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来源期刊
World Journal of Hepatology
World Journal of Hepatology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.10
自引率
4.20%
发文量
172
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