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丙型肝炎病毒3型感染患者持续病毒学应答的预测因素

Predictors of sustained virological response in patients with hepatitis C virus genotype 3 infection.

作者信息

Zarębska-Michaluk Dorota, Lebensztejn Dariusz, Chrapek Magdalena, Paluch Katarzyna, Stępień Piotr, Kryczka Wiesław

机构信息

Clinic of Infectious Diseases, Regional Polyclinical Hospital, Kielce, Poland.

Department of Pediatrics, Gastroenterology and Allergology, Medical University of Bialystok, Bialystok, Poland.

出版信息

Clin Exp Hepatol. 2016 Sep;2(3):117-124. doi: 10.5114/ceh.2016.62526. Epub 2016 Sep 26.

Abstract

AIM OF THE STUDY

To assess predictors of sustained virological response (SVR) in patients with chronic hepatitis C virus (HCV) genotype 3 treated with standard therapy.

MATERIAL AND METHODS

We retrospectively investigated data of 116 consecutive treatment-naïve patients chronically infected with HCV genotype 3, treated with pegylated interferon alpha (PegIFNα) and ribavirin (RBV) for 24 weeks. HCV RNA at week 4 (rapid virological response - RVR) and week 12 (early virological response - EVR) were measured in 85 and 105 patients respectively. Liver biopsy data were available for 103 patients. The variables were compared between patients with an SVR and those without.

RESULTS

Overall 70.7% of patients achieved an SVR. Pretreatment factors including younger age, mild liver fibrosis as well as normal values of gamma-glutamyl transferase (GGT) and platelet count were significantly associated with higher SVR rate in univariate analysis. In the multivariate analysis only baseline platelet count > 140 000/µl and normal GGT activity were correlated with higher SVR rate. At weeks 4 and 12 HCV RNA was undetectable in 34.1% and 84.8% of patients respectively. The SVR rate was significantly higher in patients with an RVR compared to those without ( = 0.002). Only 2 patients with a rapid and early virological response did not achieve an SVR; both had negative pretreatment prognostic factors.

CONCLUSIONS

In treatment-naïve patients with genotype 3 HCV infection, low baseline platelet count and elevated GGT activity were significantly associated with poor response to PegIFNα and RBV. Achieving a rapid and early virological response was associated with higher likelihood of an SVR.

摘要

研究目的

评估接受标准疗法治疗的慢性丙型肝炎病毒(HCV)3型患者持续病毒学应答(SVR)的预测因素。

材料与方法

我们回顾性研究了116例连续的初治慢性HCV 3型感染患者的数据,这些患者接受聚乙二醇化干扰素α(PegIFNα)和利巴韦林(RBV)治疗24周。分别在85例和105例患者中检测了第4周(快速病毒学应答 - RVR)和第12周(早期病毒学应答 - EVR)的HCV RNA。103例患者有肝活检数据。比较了获得SVR的患者和未获得SVR的患者之间的变量。

结果

总体上70.7%的患者实现了SVR。在单因素分析中,包括年龄较小、轻度肝纤维化以及γ-谷氨酰转移酶(GGT)和血小板计数正常等治疗前因素与较高的SVR率显著相关。在多因素分析中,仅基线血小板计数>140 000/µl和正常的GGT活性与较高的SVR率相关。在第4周和第12周,分别有34.1%和84.8%的患者HCV RNA检测不到。与未获得RVR的患者相比,获得RVR的患者SVR率显著更高(P = 0.002)。仅2例具有快速和早期病毒学应答的患者未实现SVR;两者均有阴性的治疗前预后因素。

结论

在初治的HCV 3型感染患者中,低基线血小板计数和升高的GGT活性与对PegIFNα和RBV的反应不佳显著相关。实现快速和早期病毒学应答与更高的SVR可能性相关。

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