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基于特拉匹韦的三联疗法治疗的慢性丙型肝炎患者治疗前血清干扰素-γ诱导蛋白10浓度的临床意义

Clinical significance of pretreatment serum interferon-gamma-inducible protein 10 concentrations in chronic hepatitis C patients treated with telaprevir-based triple therapy.

作者信息

Nishikawa Hiroki, Enomoto Hirayuki, Nasu Akihiro, Aizawa Nobuhiro, Saito Masaki, Tamori Akihiro, Kawada Norifumi, Kimura Toru, Osaki Yukio, Nishiguchi Shuhei

机构信息

Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan.

出版信息

Hepatol Res. 2014 Dec;44(14):E397-E407. doi: 10.1111/hepr.12326. Epub 2014 May 6.

DOI:10.1111/hepr.12326
PMID:24628684
Abstract

AIM

We aimed to determine whether pretreatment serum interferon-γ-inducible protein (IP)-10 concentration can predict response to telaprevir (TVR)-based triple therapy in patients with genotype 1 chronic hepatitis C (CHC), and to examine the effects of IP-10 concentration on liver histology.

METHODS

Baseline IP-10 concentrations were measured in 97 patients with genotype 1 CHC treated with TVR-based triple therapy, and the associations between baseline IP-10 and treatment outcome were assessed by univariate and multivariate analyses. Associations between baseline serum IP-10 concentration and laboratory data and liver histological findings were also investigated.

RESULTS

Median IP-10 concentration in these patients was 461.83 pg/mL (range, 151.35-4297.62). Multivariate analysis showed that IL28B genotype (P = 0.025) and IP-10 level (P = 0.004) were factors significantly predictive of rapid virological response (RVR), whereas in pretreatment factors only, IL28B genotype (P = 0.001) and liver fibrosis (P = 0.035) were independent predictors of sustained virological response. Using a cut-off IP-10 concentration of 460 pg/mL, patients with IL28B risk allele and low IP-10 had a significantly higher RVR rate than those with high IP-10 (P = 0.005). IP-10 concentration was significantly correlated with liver fibrosis (P = 0.001) and inflammation activity (P = 0.006) and had the highest areas under the curve for liver histological findings.

CONCLUSION

Baseline serum IP-10 level is a useful predictor of virological response in patients with genotype 1 CHC treated with TVR-based triple therapy, especially in patients with IL28B risk allele. IP-10 was well correlated with liver fibrosis and inflammation.

摘要

目的

我们旨在确定治疗前血清干扰素-γ诱导蛋白(IP)-10浓度是否可预测1型慢性丙型肝炎(CHC)患者基于特拉匹韦(TVR)的三联疗法的疗效,并研究IP-10浓度对肝脏组织学的影响。

方法

对97例接受基于TVR的三联疗法治疗的1型CHC患者测定基线IP-10浓度,并通过单因素和多因素分析评估基线IP-10与治疗结果之间的关联。还研究了基线血清IP-10浓度与实验室数据及肝脏组织学结果之间的关联。

结果

这些患者的IP-10浓度中位数为461.83 pg/mL(范围为151.35 - 4297.62)。多因素分析显示,IL28B基因型(P = 0.025)和IP-10水平(P = 0.004)是快速病毒学应答(RVR)的显著预测因素,而仅在治疗前因素中,IL28B基因型(P = 0.001)和肝纤维化(P = 0.035)是持续病毒学应答的独立预测因素。使用460 pg/mL的IP-10浓度临界值,携带IL28B风险等位基因且IP-10水平低的患者的RVR率显著高于IP-10水平高的患者(P = 0.005)。IP-10浓度与肝纤维化(P = 0.001)和炎症活动(P = 0.006)显著相关,并且在肝脏组织学结果方面曲线下面积最大。

结论

基线血清IP-10水平是接受基于TVR的三联疗法治疗的1型CHC患者病毒学应答的有用预测指标,尤其是在携带IL28B风险等位基因的患者中。IP-10与肝纤维化和炎症密切相关。

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