Hagymási Krisztina, Fehér János
Semmelweis Egyetem, Altalános Orvostudományi Kar, II. Belgyógyászati Klinika, Budapest, Szentkirályi u. 46. 1088.
Orv Hetil. 2008 Nov 16;149(46):2189-92. doi: 10.1556/OH.2008.28493.
Overweight/obesity is an independent negative predictive factor of steatosis in chronic hepatitis C virus infection. The nonresponse to combined peginterferon and ribavirin treatment in infection caused by genotype 1 is associated with the waist circumference, body mass index (BMI), diabetes, steatosis, and degree of fibrosis. The obesity is an independent negative predictive factor of inefficacy of antiviral treatment.
The authors summarize the case of a 59-year-old obese (BMI = 46.47 kg/m 2 ) male patient with chronic HCV infection. The weight reduction--after two ineffective antiviral treatments--helped the biochemical and virological response to combined peginterferon-alpha-2a and ribavirin treatment. Between the combined peginterferon and ribavirin therapy, the patient was treated with amantadine and silymarin.
The authors summarize the importance of steatosis and insulin resistance in chronic HCV hepatitis as well as review the impact of weight reduction and the improvement of insulin sensitivity.
Body-weight reduction and hepatoprotective drugs might have increased the effectiveness of combined peginterferon and ribavirin treatment and thus the sustained virological response.
超重/肥胖是慢性丙型肝炎病毒感染中脂肪变性的独立负面预测因素。基因型1感染对聚乙二醇干扰素和利巴韦林联合治疗无反应与腰围、体重指数（BMI）、糖尿病、脂肪变性及纤维化程度相关。肥胖是抗病毒治疗无效的独立负面预测因素。
作者总结了一名59岁肥胖（BMI = 46.47 kg/m²）慢性丙型肝炎病毒感染男性患者的病例。在两次抗病毒治疗无效后减轻体重，有助于对聚乙二醇干扰素-α-2a和利巴韦林联合治疗产生生化和病毒学反应。在聚乙二醇干扰素和利巴韦林联合治疗期间，该患者接受了金刚烷胺和水飞蓟宾治疗。
作者总结了脂肪变性和胰岛素抵抗在慢性丙型肝炎中的重要性，并回顾了体重减轻和胰岛素敏感性改善的影响。
体重减轻和保肝药物可能提高了聚乙二醇干扰素和利巴韦林联合治疗的有效性，从而提高了持续病毒学应答率。
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