A173 EVALUATION OF LIVER FIBROSIS SCORES POST-HCV SVR IN PEOPLE WHO INJECT DRUGS
Notice bibliographique
Résumé
In the developed world, people who inject drugs (PWID) constitute the majority of prevalent and incident Hepatitis C (HCV) infections. Treatment is often withheld due to concerns surrounding reduced efficacy related to poor adherence and a higher risk of re-infection after successful treatment. Current guidelines favour increasingly widespread access to highly effective direct-acting antiviral regimens within this population, with a view to curing HCV infection but also preventing HCV transmission. An additional rationale for treatment may be to prevent the liver-related morbidity and mortality increasingly prominent among PWID. Data on the impact of HCV cure on liver fibrosis scores among PWID have not yet been generated in a systematic way. The aim of this study is to assess the regression of fibrosis in people who inject drugs after achievement of HCV SVR. We performed a retrospective observational study utilizing records of PWID successfully treated for HCV infection at our centre. HCV-infected PWID with ongoing recreational drug use, having achieved and maintained a sustained virologic response (SVR) and engaged in long-term medical follow-up were included. Fasting transient elastography (TE) scores post-SVR were compared to pre-treatment values. If such scores were unavailable, APRI scores were considered. A cohort of 57 subjects were included in this analysis. Of these, 45 (79%) actively injected drugs during treatment and 12 (21%) did so intermittently before and after HCV treatment. The median age was 53 (27–73) years, 47 (82%) were male, 52 (91%) were Caucasian, 42 (74%) were infected with HCV genotype 1, and 12 (21%) were genotype 3. In addition, 77% were HCV treatment-naïve and 10 (18%) were HIV co-infected, 9 (90%) of whom demonstrated complete virologic suppression (HIV viral load <40 copies/mL). The mean follow-up period was 472 (128–1247) days. Based on TE evaluations, the mean pre-treatment fibrosis scores of 11.9 (3–45) kPa (3–45) significantly decreased post-treatment to a mean of 9.6 (2–27) kPa (p=0.03). Mean APRI scores decreased from 0.91 to 0.40 (p=0.0001). Among 12 patients that initially suffered from cirrhosis (TE score >12.5 kPa), 11 (92%) had improved fibrosis scores after treatment, including 5 (42%) who decreased to a lower fibrosis category (F3 or less). This data set shows significant, rapid improvement in liver fibrosis among PWID successfully treated for HCV infection. In a population where liver-related morbidity and mortality is becoming a common clinical concern, this provides additional and strong rationale for the development of strategies to increase HCV treatment uptake. Canadian Network on Hepatitis C
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».