Huang J-F, Yu M-L, Lee C-M, Dai C-Y, Hou N-J, Hsieh M-Y, Wang J-H, Lu S-N, Sheen I-S, Lin S-M, Chuang W-L, Liaw Y-F
Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Aliment Pharmacol Ther. 2007 May 1;25(9):1029-37. doi: 10.1111/j.1365-2036.2007.03297.x.
The long-term benefits of interferon-based therapy on preventing cirrhosis at non-cirrhotic stage in chronic hepatitis C patients are not fully clarified.
To evaluate the effectiveness of interferon-based therapy regarding to cirrhosis prevention in non-cirrhotic chronic hepatitis C patients.
A total of 1386 biopsy-proven, non-cirrhotic chronic hepatitis C patients (892 received interferon-based therapy and 494 untreated) were enrolled.
Fifty-six untreated and 51 treated (24 sustained virologic responders and 27 non-responders) patients developed cirrhosis during a mean follow-up period of 5.0 (1-16) and 5.1 (1-15.3) years, respectively. The annual incidences of cirrhosis in untreated and treated groups were 2.26 and 1.11% (non-responders: 1.99%, sustained responders: 0.74%), respectively. The 15-year cumulative incidence of cirrhosis was significantly lower in treated (9.9%) than untreated patients (39.8%, P = 0.0008, log-rank test). The 14.5-year cumulative incidence of cirrhosis was significantly lower in sustained responders (4.8%) compared with non-responders (21.6%, P = 0.0007) and untreated patients (36.6%, P < 0.0001). The difference was not significant between non-responders and untreated controls. Cox proportional hazards regression showed sustained virologic responders and younger age were independent negative factors for cirrhosis development.
A sustained virologic response secondary to IFN-based therapy could reduce cirrhosis development in chronic hepatitis C patients.
基于干扰素的治疗对慢性丙型肝炎患者非肝硬化阶段预防肝硬化的长期益处尚未完全阐明。
评估基于干扰素的治疗对非肝硬化慢性丙型肝炎患者预防肝硬化的有效性。
共纳入1386例经活检证实的非肝硬化慢性丙型肝炎患者（892例接受基于干扰素的治疗，494例未治疗）。
在平均5.0（1 - 16）年和5.1（1 - 15.3）年的随访期内，分别有56例未治疗患者和51例治疗患者（24例持续病毒学应答者和27例无应答者）发生肝硬化。未治疗组和治疗组肝硬化的年发病率分别为2.26%和1.11%（无应答者：1.99%，持续应答者：0.74%）。治疗组肝硬化的15年累积发病率（9.9%）显著低于未治疗患者（39.8%，P = 0.0008，对数秩检验）。持续应答者肝硬化的14.5年累积发病率（4.8%）显著低于无应答者（21.6%，P = 0.0007）和未治疗患者（36.6%，P < 0.0001）。无应答者与未治疗对照组之间差异不显著。Cox比例风险回归显示持续病毒学应答者和年轻是肝硬化发生的独立负性因素。
基于干扰素的治疗继发的持续病毒学应答可降低慢性丙型肝炎患者肝硬化的发生。
