酒精消费影响在药物治疗中心筛查的少数丙型肝炎患者的肝纤维化进展

Substance use : research and treatment Pub Date : 2025-07-07 eCollection Date: 2025-01-01 DOI:10.1177/29768357251347821
Alberto Hernández-Bustabad, Dalia Morales-Arraez, Ruth Ramos, Luz Goretti Santiago Gutiérrez, María Jesús Medina Alonso, Zaida Ramos-Marrero, Victor Pérez Pérez, Eva Molina Carballo, Felicitas Diaz-Flores, Julia Nazco, Fernando Gutiérrez, Manuel Hernández-Guerra
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引用次数: 0

摘要

背景与目的:丙型肝炎病毒(HCV)感染是药物治疗中心(DTC)的常见病。酒精滥用也可能导致DTC的肝纤维化,这可能影响HCV治疗的处方。本研究评估了酒精摄入的风险和纤维化进展的其他预测因素。方法:采用2017 - 2019年DTC丙型肝炎现场干血斑(DBS)检测方案,对既往丙型肝炎抗体检测和纤维化评分数据的患者进行识别。患者根据RNA状态、酒精摄入量和晚期肝病(ALD小于F3)进行分组。使用APRI和FIB-4评估纤维化进展。Kaplan-Meier和cox -回归分析。结果:HCV RNA阳性患者(n = 138)显示出更高的ALD发生率(11% vs 2.2%)。结论:与未感染HCV的患者相比,DTC活动性HCV感染患者发生ALD的风险增加。高风险饮酒存在于少数加重纤维化的患者中。这些结果表明,无论酒精摄入量如何,丙型肝炎治疗不应在DTC延迟。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Alcohol Consumption Impacts Liver Fibrosis Progression in Minority of Patients Screened for Hepatitis C at Drug Treatment Centers.

Background & aims: Hepatitis C virus (HCV) infection is a prevalent disease at drug treatment centers (DTC). Alcohol abuse may also contribute to liver fibrosis at DTC, which may affect the prescription of HCV therapy. This study evaluated the risk of alcohol intake and other predictive factors for fibrosis progression.

Methods: An on-site dried-blood-spot (DBS) testing program for hepatitis C care at DTC from 2017 to 2019 was used to identify patients with previous HCV-antibody testing and fibrosis score data. Patients were grouped based on RNA status, alcohol intake and advanced liver disease (ALD ⩾ F3). Fibrosis progression was assessed using APRI and FIB-4. Kaplan-Meier and Cox-regression analyses were performed.

Results: Positive HCV RNA patients (n = 138) exhibited a higher rate of ALD (11% vs 2.2%, P < .001) and a higher risk of fibrosis progression during follow-up (HR = 3.14, 95% CI: 1.2-8.2) than patients who did not have an infection (n = 230). Overall, 25% (n = 84) reported high-risk alcohol consumption, which was associated with an increased risk of ALD in patients with RNA positivity (HR = 3.2; 95% CI: 1.1-9.1). Alcohol consumption at any dose regardless of HCV infection status was not associated with ALD. Age, high-risk alcohol consumption, and RNA positivity were independent factors for progression to ALD.

Conclusions: Patients with active HCV infections at DTC have an increased risk for ALD compared to patients without HCV. High-risk alcohol consumption is present in a minority of patients aggravating fibrosis. These results suggest that HCV treatment should not be delayed at DTC regardless of alcohol consumption.

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