聚乙二醇干扰素和利巴韦林疗法对丙型肝炎病毒所致肝硬化患者治疗相关死亡率的影响
IMPACT OF THE PEGYLATED-INTERFERON AND RIBAVIRIN THERAPY ON THE TREATMENT-RELATED MORTALITY OF PATIENTS WITH CIRRHOSIS DUE TO HEPATITIS C VIRUS.
作者信息
Dresch Kelly Fernanda Nomura, Mattos Angelo Alves de, Tovo Cristiane Valle, Onofrio Fernanda Quadros de, Casagrande Leandro, Feltrin Alberi Adolfo, Barros Iago Christofoli de, Almeida Paulo Roberto Lerias de
机构信息
Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brasil.
Hospital Nossa Senhora da Conceição, Porto Alegre, RS, Brasil.
出版信息
Rev Inst Med Trop Sao Paulo. 2016;58:37. doi: 10.1590/S1678-9946201658037. Epub 2016 May 24.
UNLABELLED
Although the protease inhibitors have revolutionized the therapy of chronic hepatitis C (CHC), the concomitant use of pegylated-interferon (PEG-IFN) and ribavirin (RBV) is associated to a high rate of adverse effects. In this study, we evaluated the consequences of PEG-IFN and RBV and their relationship with mortality in patients with cirrhosis.
METHODS
Medical records of CHC who underwent treatment with PEG-IFN and RBV in a public hospital in Brazil were evaluated. All the patients with cirrhosis were selected, and their clinical and laboratory characteristics, response to treatment, side effects and mortality were evaluated.
RESULTS
From the 1,059 patients with CHC, 257 cirrhotic patients were evaluated. Of these, 45 (17.5%) achieved sustained viral response (SVR). Early discontinuation of therapy occurred in 105 (40.8%) patients, of which 39 (15.2%) were due to serious adverse effects. The mortality rate among the 257 cirrhotic patients was 4.3%, occurring in 06/242 (2.4%) of the Child-A, and in 05/15 (33.3%) of the Child-B patients. In conclusion, the treatment of patients with cirrhosis due to HCV with PEG-IFN and RBV shows a low SVR rate and a high mortality, especially in patients with liver dysfunction.
未标注
尽管蛋白酶抑制剂彻底改变了慢性丙型肝炎（CHC）的治疗方法，但聚乙二醇干扰素（PEG-IFN）和利巴韦林（RBV）联合使用会带来较高的不良反应发生率。在本研究中，我们评估了PEG-IFN和RBV的后果及其与肝硬化患者死亡率的关系。
方法
对巴西一家公立医院接受PEG-IFN和RBV治疗的CHC患者的病历进行评估。选取所有肝硬化患者，评估其临床和实验室特征、治疗反应、副作用和死亡率。
结果
在1059例CHC患者中，对257例肝硬化患者进行了评估。其中，45例（17.5%）实现了持续病毒学应答（SVR）。105例（40.8%）患者提前终止治疗，其中39例（15.2%）是由于严重不良反应。257例肝硬化患者的死亡率为4.3%，在Child-A级患者中为6/242（2.4%），在Child-B级患者中为5/15（33.3%）。总之，用PEG-IFN和RBV治疗丙型肝炎肝硬化患者显示出较低的SVR率和较高的死亡率，尤其是在肝功能不全的患者中。
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