Ruzić Maja, Milotka Fabri, Klasnja Biljana, Pobor Marta, Svarc Daniela, Jovelic Aleksandra, Fabri Izabella
Srp Arh Celok Lek. 2010 Jan-Feb;138(1-2):43-9. doi: 10.2298/sarh1002043r.
Hepatitis C Virus infection represents not just a medical, but also a socio-economic problem. It is estimated that among 170 million infected, 60% belongs to the category of intravenous drug users (IDUs).
The aim of this paper was to compare the response to the combined therapy of pegylated interferon alfa 2a and ribavirin, in the group of patients with HCV infection who were intravenous drug users (IDUs) and in patients who were identified in the other way of transmission of HCV. Also to identify the influence of the therapy on diseases of addiction, during the course of HCV infection and on the effects of the combined therapy of pegylated interferon alfa 2a and ribavirin.
We conducted a retrospective-prospective study, on 60 patients, treated with combined antiviral therapy--pegylated interferon alfa 2a and ribavirin. 30 patients were from the group of IDUs, and 30 patients from other epidemiological groups.
There were significant differences between the age of the patients (30.2 +/- 7.1 vs. 39.3 +/- 11.2 years; p = 0.002), but no significant difference in the duration of the HCV infection between the two groups of patients (8.9 +/- 7.4 vs. 13.1 +/- 7.0 years; p > 0.05). A large number of the patients in the group of IDUs had a problem with the abstinence of the drug abuse. In this group, there was the influence of alcohol (30%) and other substances with potential hepatotoxicity: marihuana (23.3%) and psychoactive drugs (73.6%). Staging of the liver fibrosis was not influenced by those two parameters and was similar in both groups (p > 0.05). The genotype 3a was dominant in intravenous drug users (50.0%) and genotype 1b in the control group of the patients (76.6%). In both groups, SVR was achieved at a higher percentage (86% vs. 70.00%; p > 0.05), but among the intravenous drug users the relapses of HCV infection were at a lower percentage (3.3% vs. 20.0%; p = 0.044). Side effects were noticed in solitary cases in both of the examined groups, but severe side effects were found only in the control group of the patients. Relapse of drug abuse was noticed in 6.66% of cases.
We have registered that the group of intravenous drug users has the same or even better response to the antiviral therapy than other epidemiological groups and that the use of drugs does not change the course of HCV infection.
丙型肝炎病毒感染不仅是一个医学问题，也是一个社会经济问题。据估计，在1.7亿感染者中，60%属于静脉注射吸毒者（IDU）。
本文旨在比较聚乙二醇化干扰素α-2a和利巴韦林联合治疗对丙型肝炎病毒感染的静脉注射吸毒者组和通过其他丙型肝炎病毒传播途径确诊的患者组的疗效。同时确定该治疗对成瘾性疾病的影响、在丙型肝炎病毒感染过程中的影响以及聚乙二醇化干扰素α-2a和利巴韦林联合治疗的效果。
我们对60例接受抗病毒联合治疗——聚乙二醇化干扰素α-2a和利巴韦林治疗的患者进行了一项回顾性-前瞻性研究。30例患者来自静脉注射吸毒者组，30例患者来自其他流行病学组。
两组患者年龄存在显著差异（30.2±7.1岁对39.3±11.2岁；p = 0.002），但两组患者丙型肝炎病毒感染持续时间无显著差异（8.9±7.4年对13.1±7.0年；p>0.05）。静脉注射吸毒者组中有大量患者存在药物滥用戒断问题。在该组中，存在酒精（30%）和其他具有潜在肝毒性物质的影响：大麻（23.3%）和精神活性药物（73.6%）。肝纤维化分期不受这两个参数影响，两组相似（p>0.05）。3a基因型在静脉注射吸毒者中占主导（50.0%），而在患者对照组中1b基因型占主导（76.6%）。两组中实现持续病毒学应答（SVR）的比例都较高（86%对70.00%；p>0.05），但静脉注射吸毒者中丙型肝炎病毒感染复发率较低（3.3%对20.0%；p = 0.044）。在两个研究组中均仅在个别病例中观察到副作用，但严重副作用仅在患者对照组中发现。6.66%的病例出现药物滥用复发。
我们记录到静脉注射吸毒者组对抗病毒治疗的反应与其他流行病学组相同甚至更好，并且药物使用不会改变丙型肝炎病毒感染的病程。
