Bura Maciej, Kowala-Piaskowska Arleta, Adamek Agnieszka, Bura Aleksandra, Czajka Arkadiusz, Hryckiewicz Katarzyna, Bereszyńska Iwona, Mozer-Lisewska Iwona
Department of Infectious Diseases, Poznan University of Medical Sciences, Poland.
Postepy Hig Med Dosw (Online). 2012 Jun 14;66:339-47. doi: 10.5604/17322693.1000332.
Hepatitis C virus (HCV) infection in Poland affects approximately 750 thousand persons. The prevention of cirrhosis and hepatocellular carcinoma, of which approximately 20% of patients with chronic hepatitis C virus are at risk, aims at eradication of the virus by applying antiviral treatment with pegylated interferon alpha with ribavirin.
MATERIAL/METHODS: In this paper the results of the standard treatment of chronic hepatitis C in a population of 169 adult patients in whom it was started in the period of 01.01.2007-30.06.2008 are analyzed. Moreover, the influence of various clinical, biochemical and viral factors on achieving therapeutic success in the form of the sustained virological response (SVR) was studied.
In the group of 128 patients who received the full course of antiviral treatment, the SVR was achieved by 67.2% of patients (86 persons), whereas regarding all 169 patients who started the therapy, the sustained disappearance of viremia was found in 53.2% of patients (90 persons). Regarding 155 persons in whom the treatment was not interrupted for reasons others than virology, this value was 55.5%. For the sustained disappearance of viremia the following was favorable: genotype 3 virus, age under 40 years, body mass up to 75 kg, correct value of body mass index (BMI), low gamma-glutamyl transpeptidase (GGTP) activity before the treatment, minimum advancement of liver fibrosis in a liver biopsy (S1), complete early biochemical response (cEBR), and moreover, the achievement of negation of viremia after 12 weeks of the treatment in a group of patients infected with genotype 1 (complete early virological response, cEVR). These factors were strongly correlated with each other and that is why an analysis by the method of logistic multiple regression was impossible. Adverse reactions to the treatment and other health problems were the reasons for earlier discontinuation of the standard therapeutic scheme in 14 patients, whereby the lack of an SVR occurred in 10 of them (71.5% which is 5.9% of the studied population).
波兰丙型肝炎病毒（HCV）感染影响约75万人。预防肝硬化和肝细胞癌（约20%的慢性丙型肝炎病毒患者有患这两种疾病的风险）旨在通过应用聚乙二醇化干扰素α联合利巴韦林进行抗病毒治疗来根除病毒。
材料/方法：本文分析了2007年1月1日至2008年6月30日期间开始接受标准治疗的169例成年慢性丙型肝炎患者的治疗结果。此外，还研究了各种临床、生化和病毒学因素对以持续病毒学应答（SVR）形式实现治疗成功的影响。
在接受完整疗程抗病毒治疗的128例患者中，67.2%（86例）的患者实现了SVR；而在所有169例开始治疗的患者中，53.2%（90例）的患者病毒血症持续消失。在155例因病毒学以外原因未中断治疗的患者中，这一数值为55.5%。病毒血症持续消失的有利因素如下：3型病毒基因型、年龄在40岁以下、体重达75千克、体重指数（BMI）值正常、治疗前γ-谷氨酰转肽酶（GGTP）活性低、肝活检中肝纤维化进展最小（S1）、完全早期生化应答（cEBR），此外，在一组感染1型基因型的患者中，治疗12周后实现病毒血症转阴（完全早期病毒学应答，cEVR）。这些因素相互之间密切相关，因此无法通过逻辑多元回归方法进行分析。治疗不良反应和其他健康问题是14例患者提前终止标准治疗方案的原因，其中10例（71.5%，占研究人群的5.9%）未实现SVR。
