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聚乙二醇干扰素联合利巴韦林治疗慢性丙型肝炎合并和不合并 HIV 感染患者肝硬度的变化。

Changes in liver stiffness in patients with chronic hepatitis C with and without HIV co-infection treated with pegylated interferon plus ribavirin.

机构信息

Unidad Clínica de Enfermedades Infecciosas, Hospital Universitario de Valme, Sevilla, Spain.

出版信息

J Antimicrob Chemother. 2010 Oct;65(10):2204-11. doi: 10.1093/jac/dkq272. Epub 2010 Jul 22.

Abstract

OBJECTIVES

To evaluate the changes in liver stiffness measurement (LSM) in patients infected by hepatitis C virus (HCV) under pegylated interferon (Peg-IFN) plus ribavirin therapy.

METHODS

One hundred and forty-three HCV-infected patients, of whom 97 (68%) were also carrying HIV, who started treatment with Peg-IFN/ribavirin were included in this prospective cohort study. The outcome variable of the study was the change in LSM between baseline and the scheduled date for evaluating sustained virological response (SVR).

RESULTS

The median (Q1-Q3) LSM values at baseline and at the SVR assessment date were 8.1 (6.2-11.6) kPa and 6.8 (5.2-9.8) kPa (P<0.001), respectively. The median (Q1-Q3) decrease between both timepoints was -1 (-2.75, 0.3) kPa. The baseline LSM decreased ≥20% in 37 (46%) patients with SVR and in 19 (30%) without SVR (P=0.05). In the linear regression analysis, baseline LSM {beta [standard error (SE)] -0.712 (0.044), P=0.004}, alcohol intake ≥50 g/day [beta (SE) 0.202 (0.030), P=0.014] and achievement of SVR [beta (SE) -0.238 (0.026), P=0.029] were independently associated with changes in LSM.

CONCLUSIONS

LSM decreases significantly among patients with chronic HCV infection who achieve SVR with Peg-IFN/ribavirin. These patients show a higher frequency of LSM reduction ≥20% at the date of SVR evaluation.

摘要

目的

评估聚乙二醇干扰素(Peg-IFN)联合利巴韦林治疗后丙型肝炎病毒(HCV)感染患者肝硬度测量(LSM)的变化。

方法

本前瞻性队列研究纳入了 143 名接受 Peg-IFN/利巴韦林治疗的 HCV 感染患者,其中 97 名(68%)患者同时携带 HIV。研究的结局变量为基线和评估持续病毒学应答(SVR)的预定日期之间 LSM 的变化。

结果

基线和 SVR 评估日期的 LSM 值中位数(Q1-Q3)分别为 8.1(6.2-11.6)kPa 和 6.8(5.2-9.8)kPa(P<0.001)。两个时间点之间的 LSM 值中位数(Q1-Q3)下降幅度为-1(-2.75,0.3)kPa。37 名(46%)SVR 患者和 19 名(30%)未 SVR 患者的基线 LSM 下降≥20%(P=0.05)。在线性回归分析中,基线 LSM(β[标准误(SE)]-0.712[0.044],P=0.004)、每日饮酒≥50g(β[SE]0.202[0.030],P=0.014)和达到 SVR(β[SE]-0.238[0.026],P=0.029)与 LSM 的变化独立相关。

结论

在接受 Peg-IFN/利巴韦林治疗并达到 SVR 的慢性 HCV 感染患者中,LSM 显著下降。这些患者在 SVR 评估日期时 LSM 降低≥20%的频率更高。

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