接受阿片类药物替代治疗的瑞典慢性丙型肝炎患者——与晚期纤维化相关的因素

Anna Jerkeman, Johan Westin, Martin Lagging, Gunnar Norkrans, Christer Lidman, Jan Frimand, Christian Simonsberg, Johan Kakko, Anders Widell, Per Björkman
{"title":"接受阿片类药物替代治疗的瑞典慢性丙型肝炎患者——与晚期纤维化相关的因素","authors":"Anna Jerkeman,&nbsp;Johan Westin,&nbsp;Martin Lagging,&nbsp;Gunnar Norkrans,&nbsp;Christer Lidman,&nbsp;Jan Frimand,&nbsp;Christian Simonsberg,&nbsp;Johan Kakko,&nbsp;Anders Widell,&nbsp;Per Björkman","doi":"10.3109/00365548.2013.879994","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Opiate substitution therapy (OST) reduces the risk of death from directly drug-related causes in heroin users, allowing other chronic health problems to emerge. People who inject drugs (PWID) are exposed to hepatitis C virus (HCV), with an associated risk of chronic liver disease. We investigated HCV prevalence and liver-related morbidity in a cohort of OST recipients, and analyzed factors associated with significant hepatic fibrosis.</p><p><strong>Methods: </strong>All patients registered on 1 April 2008 in 4 clinics providing OST in the 3 largest cities in Sweden were eligible for inclusion. HCV viremic subjects were evaluated for fibrosis stage by liver biopsy, transient elastometry (TE), and/or a biochemical fibrosis index (Göteborg University Cirrhosis Index; GUCI). Factors associated with severity of fibrosis were determined by logistic regression analysis.</p><p><strong>Results: </strong>Out of 524 eligible patients, 277 consented to enrolment. Two hundred and thirty-six subjects (88%) were anti-HCV-positive, and 162 of these were viremic (69%). Significant liver fibrosis (defined as Ishak stages F3-F6, TE value ≥ 8.85 kPa, or GUCI > 0.33) was found in 69 out of 103 (67%) tested viremic patients, and was associated with alcohol intake (p = 0.03), higher body mass index (BMI; p = 0.04), and the presence of anti-HBc antibodies (indicating exposure to hepatitis B virus (HBV); p = 0.02).</p><p><strong>Conclusions: </strong>Significant liver fibrosis was detected in two-thirds of HCV viremic OST recipients in this cohort, and was associated with alcohol use, high BMI, and exposure to HBV. These findings indicate that the management of HCV and associated risk factors should be emphasized in Swedish OST programs.</p>","PeriodicalId":21541,"journal":{"name":"Scandinavian Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2014-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/00365548.2013.879994","citationCount":"7","resultStr":"{\"title\":\"Chronic hepatitis C in Swedish subjects receiving opiate substitution therapy--factors associated with advanced fibrosis.\",\"authors\":\"Anna Jerkeman,&nbsp;Johan Westin,&nbsp;Martin Lagging,&nbsp;Gunnar Norkrans,&nbsp;Christer Lidman,&nbsp;Jan Frimand,&nbsp;Christian Simonsberg,&nbsp;Johan Kakko,&nbsp;Anders Widell,&nbsp;Per Björkman\",\"doi\":\"10.3109/00365548.2013.879994\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Opiate substitution therapy (OST) reduces the risk of death from directly drug-related causes in heroin users, allowing other chronic health problems to emerge. People who inject drugs (PWID) are exposed to hepatitis C virus (HCV), with an associated risk of chronic liver disease. We investigated HCV prevalence and liver-related morbidity in a cohort of OST recipients, and analyzed factors associated with significant hepatic fibrosis.</p><p><strong>Methods: </strong>All patients registered on 1 April 2008 in 4 clinics providing OST in the 3 largest cities in Sweden were eligible for inclusion. HCV viremic subjects were evaluated for fibrosis stage by liver biopsy, transient elastometry (TE), and/or a biochemical fibrosis index (Göteborg University Cirrhosis Index; GUCI). Factors associated with severity of fibrosis were determined by logistic regression analysis.</p><p><strong>Results: </strong>Out of 524 eligible patients, 277 consented to enrolment. Two hundred and thirty-six subjects (88%) were anti-HCV-positive, and 162 of these were viremic (69%). Significant liver fibrosis (defined as Ishak stages F3-F6, TE value ≥ 8.85 kPa, or GUCI > 0.33) was found in 69 out of 103 (67%) tested viremic patients, and was associated with alcohol intake (p = 0.03), higher body mass index (BMI; p = 0.04), and the presence of anti-HBc antibodies (indicating exposure to hepatitis B virus (HBV); p = 0.02).</p><p><strong>Conclusions: </strong>Significant liver fibrosis was detected in two-thirds of HCV viremic OST recipients in this cohort, and was associated with alcohol use, high BMI, and exposure to HBV. These findings indicate that the management of HCV and associated risk factors should be emphasized in Swedish OST programs.</p>\",\"PeriodicalId\":21541,\"journal\":{\"name\":\"Scandinavian Journal of Infectious Diseases\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2014-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.3109/00365548.2013.879994\",\"citationCount\":\"7\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Scandinavian Journal of Infectious Diseases\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3109/00365548.2013.879994\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2014/2/20 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Scandinavian Journal of Infectious Diseases","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3109/00365548.2013.879994","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2014/2/20 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 7

摘要

背景:阿片替代疗法(OST)降低了海洛因使用者直接因药物相关原因死亡的风险,从而导致其他慢性健康问题的出现。注射吸毒者(PWID)暴露于丙型肝炎病毒(HCV),具有慢性肝病的相关风险。我们调查了一组OST接受者的HCV患病率和肝脏相关发病率,并分析了显著肝纤维化的相关因素。方法:2008年4月1日在瑞典3个最大城市提供OST的4家诊所登记的所有患者均符合纳入条件。HCV病毒血症患者通过肝活检、瞬时弹性测量(TE)和/或生化纤维化指数(Göteborg大学肝硬化指数;鼓词)。通过logistic回归分析确定与纤维化严重程度相关的因素。结果:在524例符合条件的患者中,277例同意入组。236例(88%)抗hcv阳性,其中162例(69%)病毒血症。103例(67%)病毒血症患者中有69例(定义为Ishak分期F3-F6, TE值≥8.85 kPa,或GUCI > 0.33)存在显著肝纤维化,且与酒精摄入(p = 0.03)、较高的体重指数(BMI;p = 0.04),以及抗hbc抗体的存在(表明暴露于乙型肝炎病毒(HBV);P = 0.02)。结论:在该队列中,三分之二的HCV病毒血症OST受者检测到明显的肝纤维化,并与饮酒、高BMI和HBV暴露有关。这些发现表明,在瑞典的OST项目中,HCV和相关危险因素的管理应得到重视。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Chronic hepatitis C in Swedish subjects receiving opiate substitution therapy--factors associated with advanced fibrosis.

Background: Opiate substitution therapy (OST) reduces the risk of death from directly drug-related causes in heroin users, allowing other chronic health problems to emerge. People who inject drugs (PWID) are exposed to hepatitis C virus (HCV), with an associated risk of chronic liver disease. We investigated HCV prevalence and liver-related morbidity in a cohort of OST recipients, and analyzed factors associated with significant hepatic fibrosis.

Methods: All patients registered on 1 April 2008 in 4 clinics providing OST in the 3 largest cities in Sweden were eligible for inclusion. HCV viremic subjects were evaluated for fibrosis stage by liver biopsy, transient elastometry (TE), and/or a biochemical fibrosis index (Göteborg University Cirrhosis Index; GUCI). Factors associated with severity of fibrosis were determined by logistic regression analysis.

Results: Out of 524 eligible patients, 277 consented to enrolment. Two hundred and thirty-six subjects (88%) were anti-HCV-positive, and 162 of these were viremic (69%). Significant liver fibrosis (defined as Ishak stages F3-F6, TE value ≥ 8.85 kPa, or GUCI > 0.33) was found in 69 out of 103 (67%) tested viremic patients, and was associated with alcohol intake (p = 0.03), higher body mass index (BMI; p = 0.04), and the presence of anti-HBc antibodies (indicating exposure to hepatitis B virus (HBV); p = 0.02).

Conclusions: Significant liver fibrosis was detected in two-thirds of HCV viremic OST recipients in this cohort, and was associated with alcohol use, high BMI, and exposure to HBV. These findings indicate that the management of HCV and associated risk factors should be emphasized in Swedish OST programs.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
审稿时长
4-8 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信