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[坚持治疗对丙型肝炎联合治疗疗效的重要性]

[Importance of adherence for efficacy of hepatitis C combined therapy].

作者信息

Nožić Darko, Delić Dragan, Božić Milena, Fabri Milotka, Svorcan Petar, Konstantinović Ljiljana

机构信息

Clinic of Infectious and Tropical Diseases, Military Medical Academy, Belgrade, Serbia.

出版信息

Srp Arh Celok Lek. 2013 Jul-Aug;141(7-8):507-10.

Abstract

INTRODUCTION

Dual antiviral therapy with pegylated interferon alfa-2a and ribavirin leads do sustained elimination of hepatitis C virus infection in over 50% patients with genotypes 1 and 4 and in over 80% with genotypes 2 and 3. In addition to genotype, for predicting success of therapy, important factors are baseline HCV RNA level, age, sex, stage of fibrosis, insulin resistance, degree of fat in liver, and patient's weight and genetics. Also, adherence to therapy could be a very important factor associated with success of therapy.

OBJECTIVE

The aim of this study was to assess importance of therapy adherence and reduced doses of pegylated interferon alfa-2a and ribavirin on sustained virological response.

METHODS

One hundred and sixteen patients with chronic hepatitis C were analyzed. Sustained virological response was analyzed in relation to whether the patients received a full cumulative dose of pegylated interferon alfa-2a, a full cumulative dose of pegylated interferon alfa-2a and ribavirin, and a full cumulative dose of pegylated interferon alfa-2a and at least 60% the expected cumulative dose of ribavirin.

RESULTS

At the end of the follow-up period, sustained virological response was achieved in 26 (96.3%) patients who received full cumulative dose of pegylated interferon alfa-2a and in 66 (74.2%) who did not (p < 0.05). Sustained virological response was achieved in 18 (94.7%) patients who received full cumulative dose of pegylated inteferon alfa-2a and ribavirin, and in 73 (76%) who did not (p < 0.05). Sustained virological response was achieved in 25 (96.2%) patients who received full cumulative dose of pegylated inteferon alfa-2a and at least 60% of cumulative dose of ribavirin and in 66 (74.2%) who did not (p < 0.05).

CONCLUSION

These findings indicate that adherence to therapy for chronic hepatitis C is a very important factor for achieving sustained virological response.

摘要

引言

聚乙二醇化干扰素α-2a与利巴韦林联合抗病毒治疗可使超过50%的基因1型和4型丙型肝炎病毒感染患者以及超过80%的基因2型和3型患者持续清除病毒感染。除基因型外,预测治疗成功的重要因素还包括基线丙型肝炎病毒核糖核酸(HCV RNA)水平、年龄、性别、纤维化分期、胰岛素抵抗、肝脏脂肪程度、患者体重和基因。此外,治疗依从性可能是与治疗成功相关的一个非常重要的因素。

目的

本研究旨在评估治疗依从性以及聚乙二醇化干扰素α-2a和利巴韦林剂量减少对持续病毒学应答的重要性。

方法

对116例慢性丙型肝炎患者进行分析。根据患者是否接受了聚乙二醇化干扰素α-2a的全累积剂量、聚乙二醇化干扰素α-2a和利巴韦林的全累积剂量以及聚乙二醇化干扰素α-2a的全累积剂量和至少60%预期累积剂量的利巴韦林,分析持续病毒学应答情况。

结果

在随访期结束时,接受聚乙二醇化干扰素α-2a全累积剂量的26例(96.3%)患者实现了持续病毒学应答,未接受的66例(74.2%)患者实现了持续病毒学应答(p<0.05)。接受聚乙二醇化干扰素α-2a和利巴韦林全累积剂量的18例(94.7%)患者实现了持续病毒学应答,未接受的73例(76%)患者实现了持续病毒学应答(p<0.05)。接受聚乙二醇化干扰素α-2a全累积剂量和至少60%利巴韦林累积剂量的25例(96.2%)患者实现了持续病毒学应答,未接受的66例(74.2%)患者实现了持续病毒学应答(p<0.05)。

结论

这些发现表明,慢性丙型肝炎治疗的依从性是实现持续病毒学应答的一个非常重要的因素。

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