一项关于干扰素和利巴韦林治疗丙型肝炎期间黏膜皮肤药物疹的纵向队列研究。

A longitudinal cohort study of mucocutaneous drug eruptions during interferon and ribavirin treatment of hepatitis C.

机构信息

Michael E DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA.

出版信息

J Clin Gastroenterol. 2012 Feb;46(2):162-7. doi: 10.1097/MCG.0b013e318228b5f6.

DOI:10.1097/MCG.0b013e318228b5f6

PMID:21814144

Abstract

GOALS

To describe dermatologic side effects encountered during treatment of patients with chronic hepatitis C, and analyze factors predisposing to such reactions.

BACKGROUND

Treatment of hepatitis C virus (HCV) infection with interferon (IFN) and ribavirin is associated with a number of mucocutaneous adverse reactions that have not been adequately studied.

STUDY

A retrospective cohort study design was used to longitudinally describe mucocutaneous drug eruptions during IFN and ribavirin therapy in HCV-infected patients. Factors predictive of mucocutaneous eruptions were analyzed by the use of Kaplan-Meier curves and Cox proportional hazard model.

RESULTS

A total of 286 HCV-infected consecutive patients were treated with one of the IFNα formulations plus ribavirin. The mean age was 51.1 years (SD 5.6). There were 6 female patients. There were 5 patients who were also infected with human immunodeficiency virus (HIV). Fifty-six percent of the patients were white, 37% were African American, and 14% were Hispanic. Twenty-one percent of all study patients developed mucocutaneous drug eruptions. The most common drug eruptions were eczematous drug eruptions (48%), seborrheic dermatitis (11%), and xerosis (8%). Dermatologic eruptions were a contributing factor in the decision to discontinue antiviral treatment in 10% of cases. Use of Pegylated IFN formulations (hazard ratio=1.86; 95% confidence interval, 1.04-3.34) and presence of HIV coinfection (hazard ratio=4.46; 95% confidence interval, 1.61-12.92) were associated with increased rate of skin reactions.

CONCLUSIONS

Mucocutaneous reactions during IFN and ribavirin treatment of hepatitis C are common and are associated with HIV infection and use of Pegylated IFN.

摘要

目的

描述慢性丙型肝炎患者治疗过程中出现的皮肤不良反应，并分析易发生此类反应的相关因素。

背景

用干扰素（IFN）和利巴韦林治疗丙型肝炎病毒（HCV）感染会引起多种黏膜皮肤不良反应，但这些不良反应尚未得到充分研究。

研究

采用回顾性队列研究设计，对 HCV 感染患者接受 IFN 和利巴韦林治疗期间的黏膜皮肤药物疹进行纵向描述。采用 Kaplan-Meier 曲线和 Cox 比例风险模型分析预测黏膜皮肤疹的相关因素。

结果

共有 286 例连续 HCV 感染患者接受了一种 IFNα 制剂联合利巴韦林治疗。平均年龄为 51.1 岁（标准差 5.6），其中 6 例为女性，5 例合并人类免疫缺陷病毒（HIV）感染。56%的患者为白人，37%为非裔美国人，14%为西班牙裔。21%的研究患者出现黏膜皮肤药物疹。最常见的药物疹为湿疹样药物疹（48%）、脂溢性皮炎（11%）和皮肤干燥（8%）。皮肤不良反应是 10%患者决定停止抗病毒治疗的一个原因。使用聚乙二醇干扰素制剂（风险比=1.86；95%置信区间，1.04-3.34）和合并 HIV 感染（风险比=4.46；95%置信区间，1.61-12.92）与皮肤反应发生率增加相关。