Influence of hepatitis C virus infection on mortality among patients with ankylosing spondylitis

C型肝炎感染對僵直性脊椎炎病人死亡率的影響

陳之盛(Chih-Sheng Chen) ； 陳明瀚(Ming-Han Chen) ； 林永章(Yeong-Jang Lin) ； 陳昭宇(Chao-Yu Chen) ； 林峻宇(Chun-Yu Lin) ； 廖顯宗(Hsien-Tzung Liao) ； 周昌德(Chung-Tei Chou) ； 翁世蜂(Shih-Feng Weng) ； 許銘仁(Ming-Jen Sheu) ； 何宗翰(Chung-Han Ho) ； 褚錦承(Chin-Chen Chu) ； 王志中(Jhi-Joung Wang) ； 劉津秀(Chin-Hsiu Liu) ； 陳俊雄(Chun-Hsiung Chen) ； 陳宏安(Hung-An Chen)

《Formosan Journal of Rheumatology》 32卷2期 (2018/12) Pp. 16-22

https://doi.org/10.6313/FJR.201812_32(2).0003

摘要

Objectives: To determine the factors affecting long-term survival and the influence of hepatitis C virus (HCV) infection on mortality among patients with ankylosing spondylitis (AS). Methods: We used data from the National Health Insurance Research Database from 2000 to 2011. A total of 51,989 adult patients with new-onset AS were enrolled. These patients were followed from the diagnosis of AS until death or the end of 2011. We performed a Kaplan-Meier analysis of the cohort and multivariate survival analysis using Cox's regression model to determine significant predictors for survival. Results: A total of 1,129 patients (2.17%) had HCV infection at the time of diagnosis of AS. Hypertension and diabetes mellitus were the 2 most common comorbidities in AS patients. Multivariate analysis showed that age ≥ 45 years, male gender, hypertension, diabetes mellitus, coronary artery disease, stroke, and renal disease at baseline were independent predictors of long-term mortality in AS patients (p＜0.05). Patients with HCV infection had significantly higher mortality than those without. The crude mortality rate of patients infected with HCV was highest in patients with dual hepatitis B virus (HBV) and HCV infections. Conclusions: HCV infection has a great influence on mortality in patients with AS, whether those with HCV infection alone or with dual HBV and HCV infections.

關鍵字

ankylosing spondylitis ； hepatitis C virus ； mortality

並列摘要

目標：為了確認僵直性脊椎炎病人長期預後的因素，以及C型肝炎對僵直性脊椎炎病人死亡率的影響。方法：我們使用了2000年至2011年的全民健康保險研究資料庫數據。總共收錄51989個新發生的僵直性脊椎炎病人。這些病人從診斷為僵直性脊椎炎開始被追蹤直到病人死亡或者至2011年底。我們執行了Kaplan-Meier世代分析及Cox's regression模組多變異存活分析，來決定影響存活的重要因素。結果：總共1129（2.17%）個病人在診斷僵直性脊椎炎的同時已經有C型肝炎病毒感染。高血壓和糖尿病是僵直性脊椎炎病人的兩個最常見的合併症。在僵直性脊椎炎病人多變異分析顯示，收錄時年齡大於45歲、男性、高血壓、糖尿病、冠狀動脈疾病、中風、以及腎臟疾病，是預測長期死亡率的獨立因素（p＜0.05）。有C型肝炎病毒感染的病人比起沒有感染的人，有顯著更高的死亡率。而其中同時合併有B型肝炎病毒及C型肝炎病毒感染的病人的粗死亡率是最高的。結論：C型肝炎病毒感染對於僵直性脊椎炎病人有極大的影響力，不論是單獨C型肝炎病毒感染或者是合併B型肝炎病毒感染。

並列關鍵字

僵直性脊椎炎 ； C型肝炎病毒 ； 死亡率