Influencing factor on the efficacy of combined treatment of pegylated interferon-α and ribavirin in patients with chronic hepatitis C

doi:10.3877/cma.j.issn.1674-1358.2018.03.020

Abstract

Abstract:

Objective

To evaluate the influcing factors on the efficacy of combined treatment of pegylated interferon-α (PegIFN) and ribavirin (RBV) in patients with chronic hepatitis C.

Methods

The clinical data of 148 HCV-infected patients who were treated with PegIFN and RBV in Central Hospital of Baoji from January 2008 to December 2011 were analyzed, retrospectively. The sustained virological response 24 weeks (SVR24), early virological (EVR), treatment virological response (ETR), 12 weeks of sustained virological response (SVR12), recurrence, invalid response, virological breakthrough were used to evaluate the curative effect, and influencing factors of curative effect were analyzed by Logistic regression.

Results

Among the 148 patients with HCV infection, 12 (8.1%) cases were lost. Among the 136 patients with EVR, 128 (94.1%) patients experienced EVR, 118 cases (86.8%) experienced ETR, 114 (83.8%) patients experienced SVR12, 112 (82.4%) patients experienced SVR24, 8 (5.9%) patients were invalid response, 6 (4.4%) patients experienced recurrence and 4 (2.9%) patients had virological breakthrough. HCV RNA, HCV genotype and UA were all influencing factors on the efficacy of SVR24 in HCV infected patients (all P < 0.05).

Conclusions

Treatment of PegIFN combined with RBV has significant effect on HCV infection. HCV genotype 2/3, lower HCV RNA level and uric acid were associated with HCV SVR.

Key words: Hepatitis C, Pegylated interferon, Ribavirin, Uric acid

Weiwei Yang. Influencing factor on the efficacy of combined treatment of pegylated interferon-α and ribavirin in patients with chronic hepatitis C[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2018, 12(03): 301-306.

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References 22

[1]	陈晓云, 郑艳红, 金怡, 等. 聚乙二醇干扰素α联合利巴韦林治疗难治性慢性丙型肝炎过程中血常规变化与疗效的相关性[J]. 临床肝胆病杂志,2016,32(7):1319-1322.
[2]	Yan Z, Wang Y. Viral and host factors associated with outcomes of hepatitis C virus infection (Review)[J]. Mol Med Rep,2017,15(5):2909-2924.
[3]	Jadoon SA, Jadoon HA, Nazar HS. Treatment of chronic hepatitis-C with standard interferon and ribavirin[J]. J Ayub Med Coll Abbottabad,2014,26(2):212-215.
[4]	常中飞, 郑玉琴, 刘凤永, 等. 综合治疗策略对我国丙型肝炎相关性肝癌患者的预后因素分析[J/CD]. 中华实验和临床感染病杂志(电子版),2016,10(2):217-223.
[5]	Yau AH, Yoshida EM. Hepatitis C drugs: the end of the pegylated interferon era and the emergence of all-oral interferon-free antiviral regimens: a concise review[J]. Can J Gastroenterol Hepatol,2014,28(8):445-451.
[6]	Obołończyk Ł, Siekierska-Hellmann M, Wiśniewski P, et al. Epidemiology, risk factors and prognosis of Interferon alpha induced thyroid disorders. A prospective clinical study[J]. Postepy Hig Med Dosw(Online),2017,71(1):842-849.
[7]	Dolatimehr F, Karimi-Sari H, Rezaee-Zavareh MS, et al. Combination of sofosbuvir, pegylated-interferon and ribavirin for treatment of hepatitis C virus genotype 1 infection: a systematic review and meta-analysis[J]. Daru,2017,25(1):11.
[8]	Pandya P, Pant C, Taylor R, et al. Impact of sustained virological response to chronic hepatitic C antiviral therapy on new onset diabetes mellitus type 2 after controlling for metabolic syndrome[J]. J Investig Med,2017,65(4):765-771.
[9]	中华医学会肝病学分会, 中华医学会传染病与寄生虫病学分会. 丙型肝炎防治指南[J/CD]. 中华实验和临床感染病杂志(电子版),2015,9(5):590-607.
[10]	中华医学会糖尿病学分会代谢综合征研究协作组. 中华医学会糖尿病学分会关于代谢综合征的建议[J]. 中国糖尿病杂志,2004,12(3):156-161.
[11]	Ghany MG, Nelson DR, Strader DB, et al. An update on treatment of genotype 1 chronic hepatitis C virus infection: 2011 practice guideline by the American Association for the Study of Liver Diseases[J]. Hepatology,2011,54(4):1433-1444.
[12]	Polish Group of Experts for HCV, Halota W, Flisiak R, et al. Recommendations for the treatment of hepatitis C in 2017[J]. Clin Exp Hepatol,2017,3(2):47-55.
[13]	Artenie AA, Zang G, Daniel M, et al. Short-term injection drug use changes following hepatitis C virus (HCV) assessment and treatment among persons who inject drugs with acute HCV infection[J]. Int J Drug Policy,2017,47:239-243.
[14]	张馨, 汪茂荣, 杨志国, 等. 聚乙二醇化干扰素α-2a、聚乙二醇化干扰素α-2b和干扰素α-2b联合利巴韦林治疗慢性丙型肝炎的疗效[J/CD]. 中华实验和临床感染病杂志(电子版),2017,11(2):134-140.
[15]	Li Y, Wang J, Wang J, et al. SVR Rates of HCV-infected population under PEG-IFN-α/R treatment in Northwest China[J]. Virol J,2017,14(1):62.
[16]	陈志敏, 陈铿, 应若素, 等. 聚乙二醇化干扰素联合利巴韦林治疗慢性丙型肝炎的疗效及影响因素分析[J/CD]. 中华实验和临床感染病杂志(电子版),2014,8(1):22-25.
[17]	Johnson K, Green PK, Ioannou GN. Implications of HCV RNA level at week 4 of direct antiviral treatments for hepatitis C[J]. J Viral Hepat,2017,24(11):966-975.
[18]	Iqbal S, Khalil-Ur-Rahman, Sheikh MA, et al. Response of different HCV genotypes to interferon therapy in different age groups of chronic hepatitis-C patients[J]. J Ayub Med Coll Abbottabad,2014,26(3):310-315.
[19]	Yee BE, Nguyen NH, Zhang B, et al. Sustained virological response and its treatment predictors in hepatitis C virus genotype 4 compared to genotypes 1, 2, and 3: a meta-analysis[J]. BMJ Open Gastroenterol,2015,2(1):e000049.
[20]	Chen Yi, Mei SLG, Thompson AJ, et al. Sustained virological response halts fibrosis progression: A long-term follow-up study of people with chronic hepatitis C infection[J]. PLoS One,2017,12(10):e0185609.
[21]	Radley A, Tait J, Dillon JF. DOT-C: A cluster randomised feasibility trial evaluating directly observed anti-HCV therapy in a population receiving opioid substitute therapy from community pharmacy[J]. Int J Drug Policy,2017,47:126-136.
[22]	Li WC, Lee YY, Chen IC, et al. Association between the hepatitis B and C viruses and metabolic diseases in patients stratified by age[J]. Liver Int,2013,33(8):1194-1202.

一般资料	数值
年龄（ ± s，岁）	53.3 ± 10.6
性别（男/女，例）	82/66
BMI（ ± s，kg/m²）	23.2 ± 2.6
HCV RNA（ ± s，log₁₀ IU/ml）	5.7 ± 1.1
HCV基因型1︰2︰3（例）	66︰76︰6
ALT（ ± s，U/L）	62.1 ± 32.5
AST（ ± s，U/L）	63. 7 ± 38. 4
ALB（ ± s，g/L）	39.3 ± 4.2
GGT（ ± s，U/L）	44.45 ± 24.1
PLT（ ± s，× 10⁹/L）	145.4 ± 68.7
UA（ ± s，mg/dl）	5.2 ± 1.2
TC（ ± s，mg/dl）	98. 2 ± 28.5
HDL-C（ ± s，mg/dl）	42.9 ± 12.9
LDL-C（ ± s，mg/dl）	93. 2 ± 27. 6
随访时间（ ± s，月）	69.8 ± 6.4
并发症[例（%）]
糖尿病	2（1.3）
高血压	8（5.4）
代谢综合征	10（6.8）

一般资料	数值
年龄（ ± s，岁）	53.3 ± 10.6
性别（男/女，例）	82/66
BMI（ ± s，kg/m²）	23.2 ± 2.6
HCV RNA（ ± s，log₁₀ IU/ml）	5.7 ± 1.1
HCV基因型1︰2︰3（例）	66︰76︰6
ALT（ ± s，U/L）	62.1 ± 32.5
AST（ ± s，U/L）	63. 7 ± 38. 4
ALB（ ± s，g/L）	39.3 ± 4.2
GGT（ ± s，U/L）	44.45 ± 24.1
PLT（ ± s，× 10⁹/L）	145.4 ± 68.7
UA（ ± s，mg/dl）	5.2 ± 1.2
TC（ ± s，mg/dl）	98. 2 ± 28.5
HDL-C（ ± s，mg/dl）	42.9 ± 12.9
LDL-C（ ± s，mg/dl）	93. 2 ± 27. 6
随访时间（ ± s，月）	69.8 ± 6.4
并发症[例（%）]
糖尿病	2（1.3）
高血压	8（5.4）
代谢综合征	10（6.8）

组别	例数	EVR	ETR	SVR12	SVR24	无效应答	复发	病毒学突破
HCV基因型1组	60	52（86.7）	50（83.3）	46（76.7）	44（73.3）	8（13.3）	6（10.0）	2（3.3）
HCV基因型2/3组	76	76（100.0）	68（89.5）	68（89.5）	68（89.5）	0（0.0）	0（0.0）	2（2.6）
合计	136	128（94.1）	118（86.8）	114（83.8）	112（82.4）	8（5.9）	6（4.4）	4（2.9）
χ²值		10.767	1.101	4.056	6.010	10.767	7.951	0.058
P值		0.001	0.294	0.044	0.014	0.001	0.006	1.000

组别	例数	EVR	ETR	SVR12	SVR24	无效应答	复发	病毒学突破
HCV基因型1组	60	52（86.7）	50（83.3）	46（76.7）	44（73.3）	8（13.3）	6（10.0）	2（3.3）
HCV基因型2/3组	76	76（100.0）	68（89.5）	68（89.5）	68（89.5）	0（0.0）	0（0.0）	2（2.6）
合计	136	128（94.1）	118（86.8）	114（83.8）	112（82.4）	8（5.9）	6（4.4）	4（2.9）
χ²值		10.767	1.101	4.056	6.010	10.767	7.951	0.058
P值		0.001	0.294	0.044	0.014	0.001	0.006	1.000

相关因素	SVR患者（112例）	非SVR患者（24例）	统计值	P值
年龄（ ± s，岁）	55.3 ± 12.6	52.3 ± 11.6	t = 0.432	0.123
性别（男/女，例）	54/58	13/11	χ² = 0.280	0.597
BMI（ ± s，kg/m²）	23.0 ± 2.9	23.7 ± 3.6	t = 0.143	0.213
HCV RNA（ ± s，log₁₀IU/ml）	5.4 ± 1.1	6.2 ± 0.5	t = 1.576	0.022
HCV基因型（1︰2/3）	44/68	16/8	χ² = 6.010	0.014
ALT（ ± s，U/L）	78.1 ± 23.7	51.1 ± 26.9	t = 1.761	0.025
AST（ ± s，U/L）	72.7 ± 31. 4	55.9 ± 32.4	t = 0.654	0.332
ALB（ ± s，g/L）	41.2 ± 5.2	37.5 ± 3.5	t = 0.112	0.517
GGT（ ± s，U/L）	48.3 ± 25.3	42.45 ± 21.4	t = 0.154	0.219
PLT（ ± s，10⁹/L）	149.4 ± 60.1	143.4 ± 88.7	t = 0.214	0.176
UA（ ± s，mg/dl）	5.1 ± 0.6	5.8 ± 0.9	t = 1.543	0.024
TC（ ± s，mg/dl）	88.2 ± 30.5	105.2 ± 47.5	t = 1.009	0.069
HDL-C（ ± s，mg/dl）	46.3 ± 11.9	35.9 ± 10.6	t = 0.987	0.067
LDL-C（ ± s，mg/dl）	97.5 ± 21.6	83. 2 ± 22.2	t = 0.897	0.079

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