Jovanović Maja, Konstantinović Ljiljana, Kostić Velimir, Vrbić Miodrag, Popović Lidija
Klinicki centar Nis, Klinika za zarazne bolesti, Nis, Srbija.
Vojnosanit Pregl. 2009 Oct;66(10):791-5. doi: 10.2298/vsp0910791j.
BACKGROUND/AIM: The most important ethiology factor of chronic liver disease that progresses into terminal insufficiency is hepatitis C virus (HCV) infection. Intravenous (iv) drug abuse is the main cause for spreading HCV. Thus the therapy for such patients is of extreme importance in reducing the incidence of the disease. The aim of the study was to establish efficacy of a combined therapy with peginterferon alpha-2a and ribavirin in iv opiate substances abusers having chronic HCV infection in relation to sex, age, genotype and level of fibrosis and duration of HCV infection before the treatment.
Thirty one iv opiate substances abusers with chronic hepatitis C (HHC) were enrolled in the examination. The patients were divided according to the genotype into two groups. The patients with genotypes 1 and 4 (n = 18) were treated for 48 weeks, while those with genotypes 2 and 3 (n = 13) for 24 weeks. PCR HCV RNA, genotype determination and liver biopsy were done to each patient.
A stabile virological response was achieved in 93.5% of the patients, so the therapy demonstrated statistically significant efficacy i. v. opiate substances abusers with HHC (p < 0.001). There was no statistically significant difference in therapeutic response among patient groups formed according to the genotype, sex, duration of the disease and level of fibrosis (p > 0.05).
Therapy of of iv opiate substances abusers with HHC has its specificities, and these patients need special treatment. Efficacy of the therapy was equivalent in patient groups formed according to the sex, genotype, level of fibrosis and duration of HCV infection. A combined therapy with peginterferon alfa 2a and ribavirin has high level of success in the treatment of these patients.
背景/目的：进展为终末期肝功能不全的慢性肝病最重要的病因是丙型肝炎病毒（HCV）感染。静脉注射药物滥用是HCV传播的主要原因。因此，对此类患者的治疗对于降低疾病发病率极为重要。本研究的目的是确定聚乙二醇化干扰素α-2a联合利巴韦林治疗慢性HCV感染的静脉注射阿片类物质滥用者在性别、年龄、基因型、纤维化程度以及治疗前HCV感染持续时间方面的疗效。
31例慢性丙型肝炎（HHC）静脉注射阿片类物质滥用者纳入检查。患者根据基因型分为两组。基因型1和4的患者（n = 18）治疗48周，而基因型2和3的患者（n = 13）治疗24周。对每位患者进行HCV RNA聚合酶链反应、基因型测定和肝活检。
93.5%的患者实现了稳定的病毒学应答，因此该治疗对HHC静脉注射阿片类物质滥用者显示出统计学上的显著疗效（p < 0.001）。根据基因型、性别、疾病持续时间和纤维化程度分组的患者之间治疗反应无统计学显著差异（p > 0.05）。
HHC静脉注射阿片类物质滥用者的治疗有其特殊性，这些患者需要特殊治疗。根据性别、基因型、纤维化程度和HCV感染持续时间分组的患者中，治疗效果相当。聚乙二醇化干扰素α-2a联合利巴韦林的联合治疗在这些患者的治疗中成功率很高。
