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[慢性丙型肝炎持续病毒学应答的持久性:聚乙二醇干扰素联合利巴韦林治疗实现持续病毒学应答后复发相关因素分析]

[Durability of sustained virologic response in chronic hepatitis C: analysis of factors related to relapse after sustained virologic response with peginterferon plus ribavirin combination therapy].

作者信息

Lee Jang Eun, Yoon Na Ri, Kim Jin Dong, Song Myeong Jun, Kwon Jung Hyun, Bae Si Hyun, Choi Jong Young, Jeong Sung Won, Yoon Seung Kew

机构信息

Department of Internal Medicine, WHO Collaborating Center on Viral Hepatitis, The Catholic University of Korea College of Medicine, Korea.

出版信息

Korean J Gastroenterol. 2011 Mar;57(3):173-9. doi: 10.4166/2011.57.3.173.

Abstract

BACKGROUND/AIMS: Pegylated interferon plus ribavirin combination therapy has been the standard of therapy for patients with chronic hepatitis C. Although previous studies have reported long term durability after the sustained virologic response (SVR) with standard therapy for chronic hepatitis C, it is still unclear in Korea. The aim of this study was to evaluate the relapse rate and related factors after SVR to pegylated interferon therapy in Korean patients with chronic hepatitis C.

METHODS

A total of 119 chronic hepatitis C patients were treated with pegylated interferon plus ribavirin, and 73 patients achieved SVR (61.3%). Among 73 patients who achieved SVR, 68 patients (genotype 1, n=40; genotype non-1, n=28) were evaluated for virological response after SVR.

RESULTS

SVR rate in genotype 1 and genotype non-1 were 52.5%, and 65.1%, respectively. Relapse after SVR occurred in 5 patients (7.4%) with genotype 1, and the median time to relapse from SVR was 10 months. Univariate analysis revealed that the dose reduction of pegylated interferon (p=0.005) and cirrhosis (p=0.03) were significantly associated with relapse.

CONCLUSIONS

These results suggested that the relapse could occur even after SVR achievement in Korean patients with chronic hepatitis C, and the dose reduction of pegylated interferon during treatment or having cirrhosis may increased the risk for relapse.

摘要

背景/目的:聚乙二醇化干扰素联合利巴韦林的联合疗法一直是慢性丙型肝炎患者的标准治疗方法。尽管先前的研究报告了慢性丙型肝炎标准治疗获得持续病毒学应答(SVR)后的长期疗效,但在韩国这仍不明确。本研究的目的是评估韩国慢性丙型肝炎患者接受聚乙二醇化干扰素治疗获得SVR后的复发率及相关因素。

方法

共有119例慢性丙型肝炎患者接受聚乙二醇化干扰素联合利巴韦林治疗,73例患者获得SVR(61.3%)。在73例获得SVR的患者中,对68例患者(基因1型,n = 40;非基因1型,n = 28)进行了SVR后的病毒学应答评估。

结果

基因1型和非基因1型的SVR率分别为52.5%和65.1%。基因1型的5例患者(7.4%)在SVR后出现复发,从SVR到复发的中位时间为10个月。单因素分析显示,聚乙二醇化干扰素剂量减少(p = 0.005)和肝硬化(p = 0.03)与复发显著相关。

结论

这些结果表明,韩国慢性丙型肝炎患者即使在获得SVR后仍可能复发,治疗期间聚乙二醇化干扰素剂量减少或患有肝硬化可能会增加复发风险。

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