中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 12
Dec.  2014
Turn off MathJax
Article Contents

Analysis of predictive factors for rapid virologic response in treating patients with chronic hepatitis C

DOI: 10.3969/j.issn.1001-5256.2014.12.019
  • Received Date: 2014-06-04
  • Published Date: 2014-12-20
  • Objective To analyze the predictive factors for rapid virologic response (RVR) in patients with chronic hepatitis C (CHC) who received combination therapy with pegylated interferon (PEG-IFN) and ribavirin. Methods A total of 127 CHC patients who were admitted to our department from 2010 to 2012 and received PEG-IFN combined with ribavirin were enrolled in this retrospective cohort study. The patients were divided into RVR group and non-RVR (NRVR) group according to their virologic responses after 4 weeks of antiviral therapy.Demographic characteristics and the clinical features prior to treatment were compared between the two groups, and the potential factors that contributed to the acquisition of RVR were analyzed. Comparison of categorical data between groups was made by chi-square test, predictive factors were analyzed by nonparametric test for two independent samples (Mann-Whitney U test) , independent predictive factors were tested by univariate and multivariate logistic regression analyses, and the continuous variables of predictive factors were analyzed using receiver operating characteristic curves. Results Of the 127 CHC patients, 86 were males and 41 females. There were 11 confirmed cases of liver cirrhosis. There were 100 patients (78. 74%) who achieved an RVR, and 27 (21. 26%) with NRVR. Nonparametric analysis showed that eight factors, which were age, time of infection, level of pre-treatment alanine aminotransferase, level of pre-treatment hyaluronic acid, development of hypertension, type of interferon, pathway of infection, and hepatitis C virus (HCV) genotype, were significantly different between the RVR and NRVR groups (P < 0. 05) . The logistic regression analysis identified the following factors as independent predictive factors for RVR: non-genotype 1 (OR: 0. 203, 95% CI: 0. 051-0. 802, P < 0. 05) , time of infection (OR: 0. 925, 95% CI: 0. 868-0. 987, P < 0. 05) , and absence of hypertension (OR: 0. 129, 95% CI: 0. 032-0. 521, P < 0. 05) . Conclusion Patients with shorter history of HCV infection, absence of complicated hypertension, and non-genotype 1 HCV infection have an increased likelihood of achieving an RVR.

     

  • loading
  • [1]van der MEER AJ, VELDT BJ, FELD JJ, et al.Association between sustained virological response and all-cause mortality among patients with chronic hepatitis C and advanced hepatic fibrosis sustained virological response and all-cause mortality[J].JAMA, 2012, 308 (24) :2584-2593.
    [2]YU JW, WANG GQ, SUN LJ, et al.Predictive value of rapid virological response and early virological response on sustained virological response in HCV patients treated with pegylated interferon alpha-2a and ribavirin[J].J Gastroenterol Hepatol, 2007, 22 (6) :832-836.
    [3]HADZIYANNIS SJ, SETTE H JR, MORGAN TR, et al.Peginterferon-alpha 2a and ribavirin combination therapy in chronic hepatitis C:a randomized study of treatment duration and ribavirin dose[J].Ann Intern Med, 2004, 140 (5) :346-355.
    [4]FERENCI P, FRIED MW, SHIFFMAN ML, et al.Predicting sustained virological responses in chronic hepatitis C patients treated with peginterferon alfa-2a (40 KD) /ribavirin[J].J Hepatol, 2005, 43 (3) :425-433.
    [5]Chinese Society of Hepatology and Chinese Society of Infectious Diseases and Parasitology, Chinese Medical Association.Guidelines for prevention and treatment of hepatitis C[J].J Clin Hepatol, 2004, 20 (4) :197-203. (in Chinese) 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].临床肝胆病杂志, 2004, 20 (4) :197-203.
    [6]MANNS MP, MCHUTCHISON JG, GORDON SC, et al.Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C:a randomized trial[J].Lancet, 2001, 358 (9286) :958-965.
    [7]CAMMC, PETTA S, ENEA M, et al.Cost‐effectiveness of boceprevir or telaprevir for untreated patients with genotype 1 chronic hepatitis C[J].Hepatology, 2012, 56 (3) :850-860.
    [8]GILL U, AZIZ H, GILL ML.Rapid virological response tailors the duration of treatment in hepatitis C virus genotype 3 patients treated with pegylated interferon alfa-2a and ribavirin in Pakistan[J].Int J Infect Dis, 2013, 17 (11) :e1017-e1021.
    [9]CHENG ML, WANG J, ZENG AP, et al.The effects of individualized therapeutic programs on chronic hepatitis C and the influential factors of virological response[J].Chin J Intern Med, 2012, 51 (10) :751-754. (in Chinese) 程茂良, 王珏, 曾爱平, 等.慢性丙型肝炎个体化治疗及其病毒学应答效果影响因素分析研究[J].中华内科杂志, 2012, 51 (10) :751-754.
    [10]El RAZIKY M, FATHALAH WF, El AKEL WA, et al.The effect of peginterferon alpha-2a vs.peginterferon alpha-2b in treatment of naive chronic HCV genotype-4 patients:a single centre egyptian study[J].Hepat Mon, 2013, 13 (5) :e10069.
    [11]SINGAL AG, DHARIA TD, MALET PF, et al.Long-term benefit of hepatitis C therapy in a safety net hospital system:a cross-sectional study with median 5-year follow-up[J].BMJ Open, 2013, 3 (9) :e003231.
    [12]XU Z, ZHANG XH, ZHAO ZX, et al.Analysis for the predictors of rapid virological response in therapy of patients with chronic hepatitis C of high viral loads[J/CD].Chin J Clinicians:Electronic Edition, 2011, 5 (18) :5327-5330. (in Chinese) 许镇, 张晓红, 赵志新, 等.高病毒载量慢性丙型肝炎快速病毒学应答的预测因素分析[J/CD].中华临床医师杂志:电子版, 2011, 5 (18) :5327-5330.
    [13]DOU XG.The relevant factors and strategies related efficacy with standard of care in chronic hepatitis C treatment naive patients[J].Chin J Hepatol, 2013, 21 (6) :406-407. (in Chinese) 窦晓光.影响丙型肝炎初治患者标准化治疗疗效的相关因素及对策[J].中华肝脏病杂志, 2013, 21 (6) :406-407.
    [14]MARIA P, SOFIA M, RAFFAELE M, et al.Chronic HCV infection affects cardiac mass in normotensives[J].J Hepatol, 2014.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (2546) PDF downloads(576) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return