Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.
Dig Dis Sci. 2015 Feb;60(2):573-81. doi: 10.1007/s10620-014-3361-6. Epub 2014 Sep 19.
To elucidate the benefits of successful antiviral therapy in chronic hepatitis C (CHC) patients
A total of 463 CHC patients who underwent pegylated interferon alfa and ribavirin therapy were classified as sustained virological response (SVR) or non-SVR based on response to antiviral therapy. We investigated disease progression to cirrhosis in non-cirrhotic patients, development of cirrhosis-related complications such as ascites, variceal bleeding, and hepatic encephalopathy in patients with cirrhosis, and development of hepatocellular carcinoma (HCC).
Three hundred patients achieved SVR, and 163 were classified into the non-SVR group. The overall SVR rates were 64.8 %, and multivariate analysis showed that younger age, non-cirrhosis, HCV genotype 2 or 3, lower HCV RNA level (<800,000 IU/mL), and lower body weight were independent factors associated with SVR (all P < 0.05). During a median follow-up of 36.1 months, non-cirrhotic patients with SVR had significantly lower risk of progression to cirrhosis compared with patients with non-SVR (P < 0.001). Moreover, SVR was related to a reduced risk of HCC development (P = 0.017).
SVR resulted in significantly more favorable long-term outcomes, such as lower risk of progression to cirrhosis and HCC occurrence compared with non-SVR.
阐明慢性丙型肝炎(CHC)患者成功抗病毒治疗的益处。
根据抗病毒治疗的反应,将接受聚乙二醇干扰素α和利巴韦林治疗的 463 例 CHC 患者分为持续病毒学应答(SVR)或非 SVR 组。我们研究了非肝硬化患者向肝硬化的疾病进展、肝硬化患者腹水、静脉曲张出血和肝性脑病等肝硬化相关并发症的发展以及肝细胞癌(HCC)的发展情况。
300 例患者获得 SVR,163 例患者被分为非 SVR 组。总的 SVR 率为 64.8%,多因素分析显示年龄较小、非肝硬化、HCV 基因型 2 或 3、HCV RNA 水平较低(<800000IU/mL)和体重较低是与 SVR 相关的独立因素(均 P<0.05)。在中位随访 36.1 个月期间,SVR 的非肝硬化患者进展为肝硬化的风险明显低于非 SVR 患者(P<0.001)。此外,SVR 与 HCC 发生风险降低相关(P=0.017)。
与非 SVR 相比,SVR 导致的长期结局显著更有利,如肝硬化和 HCC 发生的风险降低。