Acute and chronic hepatitis C virus (HCV) infection remains a serious health problem worldwide, however, there has been advancement in the treatment of HCV infection due to standard treatment using pegylated interfero...Acute and chronic hepatitis C virus (HCV) infection remains a serious health problem worldwide, however, there has been advancement in the treatment of HCV infection due to standard treatment using pegylated interferon and ribavirin. The literature indicates that therapy for HCV is becoming more individualized. In addition to considering genotype and viral RNA levels before treatment, achievement of an early virologic response (EVR) and a rapid virologic response (RVR) is now possible during therapy. Moreover, problem patients, such as non-responders, relapsers, HIV or HBV co- infected patients, patients with liver cirrhosis, and pre- or post-liver transplantation patients are an increasing fraction of the patients requiring treatment. This article reviews the literature regarding standard treatments and problem patients with acute and chronic HCV infection. It also includes discussion on contraindications and side effects of treatment with interferon and ribavirin, as well as new drug development.展开更多
目的探讨外周血髓源性抑制细胞(MDSC)的水平与丙型肝炎病毒(HCV)感染的相关性。方法以2018年2月~2020年9月间在广州血液中心献血的109名无偿献血者为研究对象,根据抗-HCV和HCV RNA检测结果分为慢性感染者(CHC)组(n=48)、自发清除(SC)组(...目的探讨外周血髓源性抑制细胞(MDSC)的水平与丙型肝炎病毒(HCV)感染的相关性。方法以2018年2月~2020年9月间在广州血液中心献血的109名无偿献血者为研究对象,根据抗-HCV和HCV RNA检测结果分为慢性感染者(CHC)组(n=48)、自发清除(SC)组(n=29)和健康献血者对照(Control)组(n=32)。从研究对象的新鲜血样分离出外周血单个核细胞(PBMC),采用荧光标记抗体做MDSC细胞表面标志物染色,通过流式细胞术检测单核系(M-MDSC)和多形核系MDSC(PMN-MDSC)的频率;测定血浆HCV RNA、ALT、AST、GGT、TBIL和DBIL等肝功能指标。通过单因素方差分析比较3组之间外周血M-MDSC和PMN-MDSC频率以及肝功能水平的差异;组间两两比较采用Bonferroni法做多重检验校正(校正后的P值以Pc表示)。结果 CHC组、SC组和Control组的M-MDSC频率(%)分别为1.39±0.86 vs 0.85±0.63 vs 0.57±0.23(P<0.01),CHC组明显高于SC组(Pc<0.01)和Control组(Pc<0.05);PMN-MDSC频率(%)0.81±0.54 vs 0.65±0.40 vs 0.62±0.29(P>0.05)。此外,CHC组与Control组的AST(U/L)34.4±19.2 vs 23.0±7.78(Pc<0.05),GGT(U/L)为40.8±31.4 vs 22.3±7.40(Pc<0.01)。结论 HCV慢性感染者外周血M-MDSC水平明显升高,可能与HCV感染的慢性化发展有关。展开更多
文摘Acute and chronic hepatitis C virus (HCV) infection remains a serious health problem worldwide, however, there has been advancement in the treatment of HCV infection due to standard treatment using pegylated interferon and ribavirin. The literature indicates that therapy for HCV is becoming more individualized. In addition to considering genotype and viral RNA levels before treatment, achievement of an early virologic response (EVR) and a rapid virologic response (RVR) is now possible during therapy. Moreover, problem patients, such as non-responders, relapsers, HIV or HBV co- infected patients, patients with liver cirrhosis, and pre- or post-liver transplantation patients are an increasing fraction of the patients requiring treatment. This article reviews the literature regarding standard treatments and problem patients with acute and chronic HCV infection. It also includes discussion on contraindications and side effects of treatment with interferon and ribavirin, as well as new drug development.
文摘目的探讨外周血髓源性抑制细胞(MDSC)的水平与丙型肝炎病毒(HCV)感染的相关性。方法以2018年2月~2020年9月间在广州血液中心献血的109名无偿献血者为研究对象,根据抗-HCV和HCV RNA检测结果分为慢性感染者(CHC)组(n=48)、自发清除(SC)组(n=29)和健康献血者对照(Control)组(n=32)。从研究对象的新鲜血样分离出外周血单个核细胞(PBMC),采用荧光标记抗体做MDSC细胞表面标志物染色,通过流式细胞术检测单核系(M-MDSC)和多形核系MDSC(PMN-MDSC)的频率;测定血浆HCV RNA、ALT、AST、GGT、TBIL和DBIL等肝功能指标。通过单因素方差分析比较3组之间外周血M-MDSC和PMN-MDSC频率以及肝功能水平的差异;组间两两比较采用Bonferroni法做多重检验校正(校正后的P值以Pc表示)。结果 CHC组、SC组和Control组的M-MDSC频率(%)分别为1.39±0.86 vs 0.85±0.63 vs 0.57±0.23(P<0.01),CHC组明显高于SC组(Pc<0.01)和Control组(Pc<0.05);PMN-MDSC频率(%)0.81±0.54 vs 0.65±0.40 vs 0.62±0.29(P>0.05)。此外,CHC组与Control组的AST(U/L)34.4±19.2 vs 23.0±7.78(Pc<0.05),GGT(U/L)为40.8±31.4 vs 22.3±7.40(Pc<0.01)。结论 HCV慢性感染者外周血M-MDSC水平明显升高,可能与HCV感染的慢性化发展有关。
