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基线血清胆固醇与聚乙二醇干扰素 alfa-2b 和利巴韦林治疗慢性丙型肝炎基因型 2 的应答相关。

Baseline serum cholesterol is associated with a response to pegylated interferon alfa-2b and ribavirin therapy for chronic hepatitis C genotype 2.

机构信息

Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto 1-7-1, Nagasaki 852-8501, Japan.

出版信息

Gastroenterol Res Pract. 2012;2012:317580. doi: 10.1155/2012/317580. Epub 2012 Nov 5.

Abstract

Background. HCV infection is associated with lipid disorders because this virus utilizes the host lipid metabolism to sustain its life cycle. Several studies have indicated that higher concentrations of serum cholesterol and LDL before treatment are important predictors of higher rates of sustained virological response (SVR). However, most of these studies involved patients infected with HCV genotype 1. Thus, we performed a multi-institutional clinical study to evaluate the impact of lipid profiles on SVR rates in patients with HCV genotype 2. Methods. A total of 100 chronic hepatitis C patients with HCV genotype 2 who received peg-IFN alfa-2b and ribavirin therapy were consecutively enrolled. The significance of age, sex, BMI, AST level, ALT level, WBC, hemoglobin, platelet count, gamma-glutamyltransferase, total cholesterol level (TC), LDL level, HCV RNA, and histological evaluation was examined for SVR using logistic regression analysis. Results. The 100 patients infected with HCV genotype 2 were divided into 2 groups, an SVR group and a non-SVR group. Characteristics of each group were subsequently compared. There was no significant difference in the level of HCV RNA, BMI, platelet, TG, or stage of fibrosis between the groups. However, there were significant differences in the levels of TC and LDL-C. In multivariate logistic regression analysis using baseline characteristics, high TC level was an independent and significant risk factor (relative risk 18.59, P = 0.015) for SVR. Conclusion. Baseline serum total cholesterol levels should be considered when assessing the likelihood of sustained treatment response following the course of peg-IFN and ribavirin therapy in patients with chronic HCV genotype 2 infection.

摘要

背景

HCV 感染与脂质紊乱有关,因为该病毒利用宿主的脂质代谢来维持其生命周期。多项研究表明,治疗前血清胆固醇和 LDL 浓度较高是持续病毒学应答(SVR)率较高的重要预测因素。然而,这些研究大多涉及感染 HCV 基因型 1 的患者。因此,我们进行了一项多机构临床研究,以评估脂质谱对 HCV 基因型 2 患者 SVR 率的影响。

方法

连续纳入 100 例接受聚乙二醇干扰素 alfa-2b 和利巴韦林治疗的慢性丙型肝炎基因型 2 患者。使用逻辑回归分析对年龄、性别、BMI、AST 水平、ALT 水平、白细胞计数、血红蛋白、血小板计数、γ-谷氨酰转移酶、总胆固醇(TC)水平、LDL 水平、HCV RNA 和组织学评估对 SVR 的意义进行了检查。

结果

100 例感染 HCV 基因型 2 的患者分为 SVR 组和非 SVR 组。随后比较了每组的特征。两组间 HCV RNA、BMI、血小板、TG 或纤维化分期无显著差异。然而,TC 和 LDL-C 水平有显著差异。在使用基线特征的多变量逻辑回归分析中,高 TC 水平是 SVR 的独立显著危险因素(相对风险 18.59,P = 0.015)。

结论

在评估慢性 HCV 基因型 2 感染患者接受聚乙二醇干扰素和利巴韦林治疗后持续治疗反应的可能性时,应考虑基线血清总胆固醇水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc48/3501951/947f03e29dba/GRP2012-317580.001.jpg

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