Chavalitdhamrong Disaya, Tanwandee Tawesak
Division of Gastroenterology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
World J Gastroenterol. 2006 Sep 14;12(34):5532-5. doi: 10.3748/wjg.v12.i34.5532.
To assess the clinical, biochemical, and virological outcome during long-term follow-up of chronic hepatitis C patients with sustained virological response following effective antiviral therapy.
This study was a retrospective cohort study including 171 sustained responders defined as HCV RNA PCR negative at 6 mo after the end of effective antiviral treatment (SVR-6). Clinical signs and symptoms, biochemical hepatic parameters, ultrasonography and HCV RNA PCR were followed.
Mean follow-up period was 35.38 +/- 22.2 mo after the end of treatment. Twenty-seven (15.8%) responders had evidence of cirrhosis before treatment. Forty-eight (28.1%), 107 (62.6%) and 6 (3.5%) patients were genotype 1, 3, and 6 respectively, while 10 patients (5.8%) were unclassified. There were no virological and biochemical relapses during the period of follow-up. None of the patients showed evidence of hepatic decompensation. However, there were 3 patients (1.8%) developing hepatocellular carcinoma at 14, 18, 29 mo after treatment discontinuation, two of whom had evidence of cirrhosis prior to therapy.
The study shows that during a follow-up interval for about 3 years in 171 chronic hepatitis C patients with sustained viral response after effective antiviral treatment there were no evident signs of either biochemical or clinical relapse of liver disease in all but three patients who developed hepatocellular carcinoma.
评估慢性丙型肝炎患者在接受有效抗病毒治疗后获得持续病毒学应答的长期随访期间的临床、生化和病毒学转归。
本研究为一项回顾性队列研究,纳入171例持续应答者,定义为在有效抗病毒治疗结束后6个月时HCV RNA PCR检测呈阴性(SVR-6)。对临床体征和症状、肝脏生化指标、超声检查及HCV RNA PCR进行随访。
治疗结束后的平均随访期为35.38±22.2个月。27例(15.8%)应答者在治疗前有肝硬化证据。48例(28.1%)、107例(62.6%)和6例(3.5%)患者分别为基因1型、3型和6型,10例(5.8%)患者未分型。随访期间无病毒学和生化复发。所有患者均无肝失代偿证据。然而,有3例患者(1.8%)在停药后14、18和29个月发生肝细胞癌,其中2例在治疗前有肝硬化证据。
该研究表明,在171例慢性丙型肝炎患者接受有效抗病毒治疗后获得持续病毒应答的约3年随访期内,除3例发生肝细胞癌的患者外,所有患者均无明显的肝脏疾病生化或临床复发迹象。