Todorovska Beti, Joksimovic Nenad, Caloska-Ivanova Viktorija, Dimitrova-Genadieva Magdalena, Trajkovska Meri, Curakova Elena, Kiprijanovska Sanja, Zafirova-Ivanovska Beti, Serafimoski Vladimir
University Clinic of Gastroenterohepatology, Faculty of Medicine, University "Ss. Cyril and Methodius", Skopje.
Research Center for Genetic Engineering and Biotechnology "Georgi D. Efremov", Macedonian Academy of Sciences and Arts, Skopje.
Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2017 Mar 1;38(1):25-33. doi: 10.1515/prilozi-2017-0003.
The success of the antiviral treatment in patients with chronic hepatitis C depends on the factors related to the virus and the host. The aim of the study is the analysis of the antiviral therapy which is a combination of pegylated interferon and ribavirin, considering various factors that will identify the predictors of the sustained virological response.
This retrospective study included 226 patients, divided in two groups. Patients with sustained virological response and patients without sustained virological response were compared in terms of the following factors: genotype, viral load, gender, age, inflammatory and fibrotic changes in the liver, metabolic abnormalities, obesity and fatty liver.
The rate of the sustained virological response is 83.6%, more frequently in patients with genotype 3, with evidenced statistical significance (90.54%). The factors that significantly contribute to sustained virological response are related to the age (p = 0.0001), genotype (p = 0.002), mode of transmission (p = 0.005), inflammatory changes in the liver (p = 0.028), body mass index (p = 0.022) and insulin resistance (p = 0.039). The high rate of sustained virological response is related to the younger age of the patients which indirectly means short Hepatitis C Virus infection duration, absence of advanced liver disease and lack of significant co-morbid conditions. Single confirmed independent predictors of sustained virological response are the age (OR 0.928, p = 0.0001) and genotype (OR 3.134, p = 0.005).
Factors that are related to the virological response are the age, genotype, mode of transmission, inflammatory changes in the liver, body mass index and insulin resistance, but still, independent predictors of sustained virologic response are the age and the genotype.
慢性丙型肝炎患者抗病毒治疗的成功取决于与病毒和宿主相关的因素。本研究旨在分析聚乙二醇化干扰素和利巴韦林联合的抗病毒治疗，考虑各种因素以确定持续病毒学应答的预测指标。
这项回顾性研究纳入了226例患者，分为两组。对获得持续病毒学应答的患者和未获得持续病毒学应答的患者在以下因素方面进行比较：基因型、病毒载量、性别、年龄、肝脏的炎症和纤维化改变、代谢异常、肥胖和脂肪肝。
持续病毒学应答率为83.6%，在基因3型患者中更为常见，具有统计学意义（90.54%）。对持续病毒学应答有显著贡献的因素与年龄（p = 0.0001）、基因型（p = 0.002）、传播方式（p = 0.005）、肝脏炎症改变（p = 0.028）、体重指数（p = 0.022）和胰岛素抵抗（p = 0.039）有关。持续病毒学应答率高与患者年龄较轻有关，这间接意味着丙型肝炎病毒感染持续时间短、无晚期肝病且无严重合并症。持续病毒学应答的单一确定独立预测指标是年龄（OR 0.928，p = 0.0001）和基因型（OR 3.134，p = 0.005）。
与病毒学应答相关的因素是年龄、基因型、传播方式、肝脏炎症改变、体重指数和胰岛素抵抗，但持续病毒学应答的独立预测指标仍然是年龄和基因型。
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