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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患者的长期疗效。

Long-term outcome of chronic hepatitis C patients with sustained virological response to peginterferon plus ribavirin.

机构信息

Gastroenterology-Hepatology Department, University Hospital La Princesa and Princesa Research Institute, Autonomous University of Madrid and CIBERehd, C/Diego de León 62, Madrid, Spain.

出版信息

World J Gastroenterol. 2011 Jan 28;17(4):493-8. doi: 10.3748/wjg.v17.i4.493.

Abstract

AIM

To assess the clinical, biochemical and virological long-term outcome in chronic hepatitis C (CHC) patients with a sustained virological response (SVR) after peginterferon (PEG-IFN) plus ribavirin combination therapy.

METHODS

One hundred and fifty three patients with a SVR after treatment with PEG-IFN plus ribavirin were included in a 5-year follow-up study in a single Spanish center, based on standard clinical practice. Clinical anamnesis, biochemical analysis, hepatitis C virus RNA and alpha-fetoprotein measurement, ultrasonography and transient elastography were performed annually.

RESULTS

The mean follow-up period of the 153 patients was 76 ± 13 mo after they obtained a SVR. Five patients (3.26%) presented with cirrhosis before treatment and 116 (75.8%) had genotype 1. No patient showed evidence of hepatic decompensation. One patient (0.65%) developed a hepatocellular carcinoma at month 30 after achieving SVR. There were no virological relapses during this follow-up period. Persistently elevated alanine aminotransferase was found in only one patient (0.65%). At the end of the 5-year follow-up, the mean value of transient elastography was 7 ± 4.3 kPa (F1). There were no deaths and no other tumors.

CONCLUSION

The long-term outcome of 153 CHC patients with SVR to PEG-IFN plus ribavirin was good. No evidence of a virological relapse was seen. One patient (0.65%) developed a hepatocellular carcinoma.

摘要

目的

评估慢性丙型肝炎(CHC)患者在聚乙二醇干扰素(PEG-IFN)加利巴韦林联合治疗后获得持续病毒学应答(SVR)的临床、生化和病毒学的长期结果。

方法

在西班牙的一个单中心,153 例接受 PEG-IFN 加利巴韦林治疗后获得 SVR 的患者纳入了一项为期 5 年的随访研究,依据标准临床实践。每年进行临床病史、生化分析、丙型肝炎病毒 RNA 和甲胎蛋白检测、超声和瞬时弹性成像检查。

结果

153 例患者获得 SVR 后平均随访 76±13 个月。5 例患者(3.26%)在治疗前存在肝硬化,116 例(75.8%)为基因型 1。无患者出现肝功能失代偿的证据。1 例患者(0.65%)在获得 SVR 后 30 个月发生肝细胞癌。在此随访期间无病毒学复发。仅有 1 例患者(0.65%)出现持续的丙氨酸氨基转移酶升高。在 5 年随访结束时,瞬时弹性成像的平均数值为 7±4.3kPa(F1)。无死亡和其他肿瘤。

结论

153 例接受 PEG-IFN 加利巴韦林治疗获得 SVR 的 CHC 患者的长期结果良好。未发现病毒学复发的证据。1 例患者(0.65%)发生肝细胞癌。

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