Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy.
Aliment Pharmacol Ther. 2010 Feb 15;31(4):502-8. doi: 10.1111/j.1365-2036.2009.04201.x. Epub 2009 Nov 19.
There are few data in the literature regarding the long-term virological follow-up of chronic hepatitis C patients who obtain sustained virological response (SVR) to pegylated interferon (PEG-IFN) and ribavirin therapy.
To assess the durability of SVR to PEG-IFN and ribavirin therapy during long-term follow-up of chronic hepatitis C patients.
We evaluated a cohort of 231 chronic hepatitis C patients who had at least 48 weeks of follow-up after SVR to PEG-IFN and ribavirin treatment. Median duration of follow-up after SVR was 164 weeks, and exceeded 5 years in 30% of the cohort. Patients underwent consistent clinical, biochemical and virological evaluations every 6 months during follow-up.
Sustained virological response was maintained in 211 patients (91%) while HCV-RNA became positive in two patients (<1%) within 1 year after SVR, and in 18 patients (8%) serum HCV-RNA was transiently positive in at least one follow-up evaluation. Clinical outcome was not significantly different between patients with persistently negative and transiently positive serum HCV-RNA.
Sustained virological response to PEG-IFN and ribavirin is maintained in 99% of patients during long-term follow-up. Late virological relapse occurred within 1 year after SVR and, from a clinical perspective, patients can be considered cured of infection after this period.
关于获得聚乙二醇干扰素（PEG-IFN）和利巴韦林治疗慢性丙型肝炎患者持续病毒学应答（SVR）后的长期病毒学随访，文献中数据较少。
评估慢性丙型肝炎患者在 SVR 后接受 PEG-IFN 和利巴韦林治疗的长期随访期间 SVR 的持久性。
我们评估了 231 例慢性丙型肝炎患者的队列，这些患者在 SVR 后至少有 48 周的随访。SVR 后随访的中位时间为 164 周，30%的队列超过 5 年。在随访期间，患者每 6 个月接受一次一致的临床、生化和病毒学评估。
211 例患者（91%）维持了持续的病毒学应答，而 2 例患者（<1%）在 SVR 后 1 年内 HCV-RNA 转为阳性，18 例患者（8%）在至少一次随访评估中血清 HCV-RNA 呈一过性阳性。持续阴性和一过性阳性血清 HCV-RNA 的患者临床结局无显著差异。
在长期随访中，99%的患者对 PEG-IFN 和利巴韦林的持续病毒学应答得以维持。SVR 后 1 年内发生晚期病毒学复发，从临床角度来看，在此期间可认为患者已治愈感染。
