摘要
目的探讨慢性丙型肝炎(CHC)抗病毒治疗后复发的预测因素及时间规律。方法聚乙二醇干扰素联合利巴韦林治疗CHC。荧光定量PCR法检测HCV RNA,CE1区测序法检测HCV基因型。结果 113例患者中有100例获得治疗末病毒学应答,14例复发。HCV1型复发率(21.6%)高于HCV2型(13.3%)、HCV3型(10.3%)和HCV6型(5.3%)(P=0.345)。年龄≤40岁的复发率(10.8%)低于年龄>40岁者(20.6%);男性(9.8%)低于女性(20.5%),高ALT(8.6%)低于低ALT(21.4%),但差异均无统计学意义(P=0.204、0.133、0.068)。高HCV RNA的复发率(14.3%)与低HCV RNA(13.7%)相近(P=0.936)。获得完全快速病毒学应答(RVR)的复发率(8.5%)低于仅获得部分RVR(23.1%)和未获得RVR(33.3%);获得完全早期病毒学应答(EVR)(13.7%)低于仅获得部分EVR(50.0%);但差异均无统计学意义(P=0.174、0.148)。停药后3个月内复发多见,未见停药6个月以上复发者。结论治疗过程中病毒转阴越早复发率越低,复发在3个月内最多。
Objective To investigate potential predictive factors of relapse after antiviral treatment in patients with chronic hepatitis C virus （HCV） infection, and explore the temporal characteristics of relapse. Methods One - hundred - and - thirteen patients with chronic HCV received pegylated interferon and ribavirin combination therapy. HCV1 type was treated for 48 weeks and non - HCV1 types were treated for 24 weeks. Serum HCV RNA was measured with real - time quantitative reverse - transcription polymerase chain reaction. HCV genotypes were determined by sequencing of the HCV core - envelopel region, followed by phylogenic analysis. Results The majority （88.5% , 100/113） of patients achieved virological response, and 14.0% （14/100） relapsed after stopping treatment. The rate of relapse was higher for HCV1 infections （21.6%） than for HCV2 （ 13.3% ）, HCV3 （ I0.3% ）, or HCV6 （5.3%） infections, hut the differences were not statistically significant （P =0.345）. The rate of relapse was lower in patients ~〈40 years old （ 10.8% vs 〉40 years old： 20.6% ）, men （9.8% vs women： 20.5%） , and patients with elevated alanine aminotransferase （ 〉80 U/mL： 8.6% vs 80 U/mL： 21.4%） , but the differences were not statistically significant （P = 0. 204, P = 0. 133, and P = 0. 068, respectively）. Patients with higher HCV RNA （ 14. 3% ） experienced similar relapse rates to those with lower HCV RNA （ 13.7%, P =0. 936）. Patients who achieved complete rapid vir- ological response （ 8.5 % ） had lower relapse rate than those with partial rapid virological response （23.1% ） and those with no rapid virolog- ical response （33.3%）, while patients who achieved complete early virological response （ 13.7% ） also had lower relapse rate than those with partial early virological response （50.0%） ; however, none of the intergroup differences were statistically significant （rapid： P = 0.174 and early： P = 0. 148 ）. Most relapses occured in less than three months
出处
《临床肝胆病杂志》
CAS
2012年第8期609-611,共3页
Journal of Clinical Hepatology
关键词
肝炎
丙型
慢性
复发
基因型
抗病毒药
hepatitis C, chronic
recurrence
genotype
antiviral agents
