World J Gastroenterol. 2009 Oct 28;15(40):4993-9. doi: 10.3748/wjg.15.4993.
Several studies have demonstrated that the outcome of chronic hepatitis C (CHC) infection is profoundly influenced by a variety of comorbidities. Many of these comorbidities have a significant influence on the response to antiviral therapy. These comorbidities negatively affect the course and outcome of liver disease, often reducing the chance of achieving a sustained virological response with PEGylated interferon and ribavirin treatments. Comorbidities affecting response to antiviral therapy reduce compliance and adherence to inadequate doses of therapy. The most important comorbidities affecting the course of CHC include hepatitis B virus coinfection, metabolic syndrome, and intestinal bacterial overgrowth. Comorbidities affecting the course and response to therapy include schistosomiasis, iron overload, alcohol abuse, and excessive smoking. Comorbidities affecting response to antiviral therapy include depression, anemia, cardiovascular disease, and renal failure.
多项研究表明，慢性丙型肝炎（CHC）感染的结局受到多种合并症的显著影响。这些合并症中有许多对抗病毒治疗的反应有重大影响。这些合并症会对肝病的病程和结局产生负面影响，常常降低患者经聚乙二醇干扰素和利巴韦林治疗获得持续病毒学应答的机会。影响抗病毒治疗应答的合并症会降低对治疗剂量不足的顺应性和坚持性。影响 CHC 病程的最重要合并症包括乙型肝炎病毒合并感染、代谢综合征和肠道细菌过度生长。影响病程和治疗应答的合并症包括血吸虫病、铁过载、酒精滥用和过度吸烟。影响抗病毒治疗应答的合并症包括抑郁、贫血、心血管疾病和肾衰竭。
