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慢性丙型病毒性肝炎患者治疗反应的阳性和阴性预测因素

Positive and Negative Predictive Factors for Treatment Response in Patients with Chronic Viral C Hepatitis.

作者信息

Kamal Adina Maria, Mitruț P, Ciobanu Alexandra Dana, Kamal C K, Tica Oana Sorina, Tica A A

机构信息

Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, Romania.

Department of Family Medicine, University of Medicine and Pharmacy of Craiova, Romania.

出版信息

Curr Health Sci J. 2017 Oct-Dec;43(4):318-324. doi: 10.12865/CHSJ.43.04.05. Epub 2017 Dec 28.

Abstract

More than 200 million people worldwide are infected with hepatitis C virus. In the United States, suggested estimates are that more than 5 million people live with HCV. The purpose of this paper is to identify, within the Southwestern Romanian population, host factors associated with the response to Pegylated Interferon and Ribavirin treatment for Hepatitis C virus infection. We investigated several factors and their correlation to sustained virological response. The study included 267 patients diagnosed with chronic Hepatitis C between 2013 and 2016, treated with Pegylated Interferon and Ribavirin in the 2nd Medical Department of the Emergency County Hospital Craiova. From the 267 patients included in this study, 149 (55,81%) achieved sustained virological response during the 48 weeks of treatment. Several factors were taken in consideration regarding the treatment response. Positive predictive factors for achieving sustained virological response were: the female gender (35,96%), Low Viral Load at the beginning of treatment, Early Virological Response 75 (28,09%), Rapid Virologic Response133 (49,81%), and stage of fibrosis, with Stage F1 having the highest rate of Sustained Virological Response during double therapy 81 (30,34%). Although at the present time a number of more effective antiviral products have been approved for the treatment of viral hepatitis C, in our country the standard of treatment remains with PegInterferon and Ribavirin therapy. Multiple clinical and paraclinical tools can identify patients with a high chance of responding to treatment, or those who, during treatment, do not meet the criteria for prolonging therapy.

摘要

全球有超过2亿人感染丙型肝炎病毒。在美国,据估计有超过500万人感染丙型肝炎病毒。本文旨在确定罗马尼亚西南部人群中,与聚乙二醇干扰素和利巴韦林治疗丙型肝炎病毒感染反应相关的宿主因素。我们研究了几个因素及其与持续病毒学应答的相关性。该研究纳入了2013年至2016年间在克拉约瓦县急救医院第二内科被诊断为慢性丙型肝炎、接受聚乙二醇干扰素和利巴韦林治疗的267例患者。在这项研究纳入的267例患者中,149例(55.81%)在48周的治疗期间实现了持续病毒学应答。关于治疗反应考虑了几个因素。实现持续病毒学应答的阳性预测因素为:女性(35.96%)、治疗开始时病毒载量低、早期病毒学应答75例(28.09%)、快速病毒学应答133例(49.81%)以及纤维化阶段,在联合治疗期间F1期持续病毒学应答率最高,为81例(30.34%)。尽管目前已有多种更有效的抗病毒产品被批准用于治疗丙型病毒性肝炎,但在我国,治疗标准仍然是聚乙二醇干扰素和利巴韦林疗法。多种临床和辅助检查手段可以识别出对治疗反应可能性高的患者,或者那些在治疗期间不符合延长治疗标准的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5521/6286456/806f3f694f5a/CHSJ-43-04-05.fig1.jpg

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