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印度北部一家三级医疗中心丙型肝炎病毒(HCV)感染患者的HCV基因型流行率及直接抗病毒治疗对临床和实验室参数影响的研究

A Study on the Prevalence of HCV Genotypes and the Effect of Direct-Acting Antiviral Therapy on Clinical and Laboratory Parameters in HCV-Infected Patients at a Tertiary Care Center in North India.

作者信息

Shahanas S Muhammed, Verma Rajeev, Kumar Kanishka, Verma Manisha, Srivastavsa Deepak Chandra, Budhwani Priyanka

机构信息

Department of Medicine, Manipal Hospital, Bengaluru, Karnataka, India.

Department of Medicine, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, India.

出版信息

Indian J Community Med. 2024 Jan-Feb;49(1):203-208. doi: 10.4103/ijcm.ijcm_865_22. Epub 2024 Jan 12.

Abstract

BACKGROUND

The purpose of this study was to investigate the prevalence and distribution of different HCV genotypes, as well as to evaluate clinical and laboratory parameters in HCV-infected patients before and after DAA treatment.

MATERIAL AND METHODS

An open-label prospective study was conducted on 50 HCV-infected individuals. The HCV-infected patients underwent a baseline evaluation with complete history, examination, and other clinical investigations. These patients received the appropriate DAA according to the genotype for 3 months. At the end of 3 months, these patients were again evaluated clinically.

RESULTS

The majority of instances were among younger age groups. Genotype 3 (66%) was the most common. There was a statistically significant difference found in clinical parameters regarding total bilirubin (p=0.008), SGOT (p=0.001), SGPT (p=0.035), ALP (p=<0.001) and Blood Urea Nitrogen (p = 0.004). When 1a vs 1b intragroup comparison was drawn, there was a significant mean difference found in SGOT (p value= 0.053) and Creatinine (p=0.050) parameters while rest shows no significant difference when associated. In the comparison of 1a vs 3 or 4, none of the parameters shows significant difference while; when 1b vs 3 or 4 comparison was laid out, SGOT and Creatinine was found near to significant.

CONCLUSION

This study concludes that with the availability of DAAs, highly effective, short-duration, and safe regimens have created better outcomes for patients with HCV infection, especially in those groups where SVR was low with prior therapies or in those where IFN-based treatment strategies were contraindicated.

摘要

背景

本研究的目的是调查不同丙型肝炎病毒(HCV)基因型的流行情况和分布,以及评估直接抗病毒药物(DAA)治疗前后HCV感染患者的临床和实验室参数。

材料与方法

对50例HCV感染个体进行了一项开放标签的前瞻性研究。HCV感染患者接受了包括完整病史、检查和其他临床检查的基线评估。这些患者根据基因型接受适当的DAA治疗3个月。在3个月末,对这些患者再次进行临床评估。

结果

大多数病例发生在较年轻的年龄组。基因型3(66%)最为常见。在总胆红素(p = 0.008)、谷草转氨酶(SGOT,p = 0.001)、谷丙转氨酶(SGPT,p = 0.035)、碱性磷酸酶(ALP,p < 0.001)和血尿素氮(p = 0.004)的临床参数方面发现有统计学显著差异。当进行1a与1b组内比较时,在SGOT(p值 = 0.053)和肌酐(p = 0.050)参数方面发现有显著的平均差异,而其他参数在关联时无显著差异。在1a与3或4的比较中,所有参数均无显著差异;而在1b与3或4的比较中,SGOT和肌酐接近显著差异。

结论

本研究得出结论,随着DAA的出现,高效、短疗程且安全的治疗方案为HCV感染患者带来了更好的治疗效果,尤其是在那些既往治疗中持续病毒学应答(SVR)率低的群体或那些基于干扰素的治疗策略为禁忌的群体中。

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