Kan Toshiki, Hashimoto Senju, Kawabe Naoto, Nakano Takuji, Nakaoka Kazunori, Yoshioka Kentaro
Department of Liver, Biliary Tract and Pancreas Diseases, Fujita Health University, Aichi470-1192, Japan.
J Transl Int Med. 2017 Sep 30;5(3):148-154. doi: 10.1515/jtim-2017-0028. eCollection 2017 Sep.
To elucidate the mechanism of an increase in the albumin levels by daclatasvir (DCV)/asunaprevir (ASV) therapy, we assessed the factors associated with an increase in the albumin levels.
We retrospectively analyzed 125 patients with chronic hepatitis C virus (HCV) infection, treated with DCV/ASV from November 2014 to January 2016.
Albumin levels significantly increased from 4.0 ± 0.4 g/dL at baseline to 4.2 ± 0.4 g/dL at 24 weeks after the end of treatment (EOT) ( < 0.0001) in 108 patients with SVR. Patients with SVR were divided into three groups according to their baseline albumin levels: group A, ≥ 4 g/dL; group B, 3.6-3.9 g/dL; and group C, ≤ 3.5 g/dL. The increase in albumin levels from baseline to at 24 weeks after EOT was significantly larger in group C (0.5 ± 0.5 g/dL, < 0.0001) and group B (0.2 ± 0.4 g/dL, = 0.0059) than in group A (0.0 ± 0.3 g/dL). Multivariate analysis showed that aspartate transaminase (AST) levels was the only factor associated with ≥ 0.3 g/dL increase in albumin levels in groups B and C ( = 0.0305). An increase in albumin levels was significantly correlated with a decrease in AST levels ( = 0.4729, = 0.0119).
DCV/ASV therapy resulted in an increase in albumin levels in SVR patients, which was significantly correlated with a decrease in AST levels. It is probable that the reduction of inflammation, but not by reduction of fibrosis, mainly caused an increase in albumin levels.
为阐明达卡他韦（DCV）/阿舒瑞韦（ASV）治疗使白蛋白水平升高的机制，我们评估了与白蛋白水平升高相关的因素。
我们回顾性分析了2014年11月至2016年1月期间接受DCV/ASV治疗的125例慢性丙型肝炎病毒（HCV）感染患者。
108例获得持续病毒学应答（SVR）的患者，白蛋白水平从基线时的4.0±0.4 g/dL显著升高至治疗结束（EOT）后24周时的4.2±0.4 g/dL（<0.0001）。根据基线白蛋白水平，将获得SVR的患者分为三组：A组，≥4 g/dL；B组，3.6 - 3.9 g/dL；C组，≤3.5 g/dL。从基线到EOT后24周，白蛋白水平的升高在C组（0.5±0.5 g/dL，<0.0001）和B组（0.2±0.4 g/dL，=0.0059）中显著大于A组（0.0±0.3 g/dL）。多因素分析显示，天冬氨酸转氨酶（AST）水平是B组和C组中与白蛋白水平升高≥0.3 g/dL相关的唯一因素（=0.0305）。白蛋白水平的升高与AST水平的降低显著相关（=0.4729，=0.0119）。
DCV/ASV治疗使SVR患者的白蛋白水平升高，这与AST水平的降低显著相关。白蛋白水平升高可能主要是由于炎症减轻，而非纤维化减轻所致。
