更糟糕的是，B型肝炎或C型肝炎？

StephenW

http://general-medicine.jwatch.org/cgi/content/full/2012/920/1?q=pfw-featured
Which Is Worse, Hepatitis B or Hepatitis C?

Chronic hepatitis B infection was associated with higher liver-related mortality.

Chronic hepatitis B and chronic hepatitis C virus infections are both potentially fatal conditions, but few head-to-head comparisons of clinical outcomes have been attempted.

Among almost 7000 American men included in a large prospective database of men who have sex with men, about 5% of participants entered the study with each type of chronic hepatitis. After a median follow-up of almost 8 years, all-cause mortality was similar in both groups, but liver-related mortality was significantly higher for those with chronic hepatitis B infections. This finding held true for both HIV-negative and HIV-positive participants, including those who were severely immunocompromised.

Excluding the few men in the study who underwent treatment for hepatitis C infection did not change the pattern. However, liver-related mortality among participants who were coinfected with hepatitis B and HIV and who were enrolled after 2002 was markedly lower than among those who were enrolled earlier, possibly reflecting use of newer antiviral drugs that are active against both HIV and hepatitis B virus.

Comment: This study is the first in which the effects of hepatitis B and hepatitis C virus infections were compared in a relatively homogeneous population. Its results are worth noting because a surge of public health advertisements have brought hepatitis C screening and treatment into the public eye recently. Clinicians should remember that, despite vaccination, hepatitis B is still out there, and effective oral treatment can save lives.

— Abigail Zuger, MD

Published in Journal Watch General Medicine September 20, 2012
Citation(s):

Falade-Nwulia O et al. Comparative risk of liver-related mortality from chronic hepatitis B versus chronic hepatitis C virus infection. Clin Infect Dis 2012 Aug 15; 55:507. (http://dx.doi.org/10.1093/cid/cis432)

StephenW

更糟糕的是，B型肝炎或C型肝炎？

慢性B型肝炎感染与肝脏相关死亡率较高的。

慢性乙型肝炎和慢性丙型肝炎病毒感染潜在致命性的条件，但已经尝试了几头对麦芒的比较的临床疗效。

在近7000美国男人中的男人发生性关系的男人在一个大的前瞻性数据库中，大约有5％的参与者进入每种类型的慢性丙型肝炎的研究。后平均随访近8年来，各种原因的死亡率在两组相似，但肝脏相关死亡率显着高于那些有慢性B型肝炎感染。举行这一发现为HIV阴性和HIV阳性的人，包括那些严重免疫功能低下的人。

不包括几名男子在接受治疗丙型肝炎病毒感染的研究并没有改变的格局。然而，参与者之间的合并感染B型肝炎和艾滋病毒，被纳入2002年后的肝脏相关死亡率显着低于患者早期的那些，这可能反映使用较新的抗病毒药物，有效地防治艾滋病毒和乙肝病毒。

评论：这项研究是第一个在一个相对均匀的人口中，B型肝炎和C型肝炎病毒感染的效果进行了比较。其结果是值得注意的，因为一股公共卫生广告带来了丙型肝炎的筛查和治疗最近进入公众视线。临床医生应该记住的是，尽管接种了疫苗，B型肝炎是仍然在那里，和有效的口服药物治疗可以挽救生命。

- 阿比盖尔Zuger，MD

全科医学杂志手表九月20，2012年出版
参考文献（S）：

Falade Nwulia O等人。比较慢性B型肝炎与慢性丙型肝炎病毒感染的肝脏相关死亡率的风险。感染2012年8月15日55:507。 （http://dx.doi.org/10.1093/cid/cis432）