吉林大学第一医院肝胆胰内科 于鸽 摘译
本文首次发表于[Zhonghua Gan Zang Bing Za Zhi. 2012,20(2):112-115. ]
Peg-IFNα-2a/RBV antiviral efficacy in cirrhotic hepatitis C patients after splenectomy or partial splenic embolization
Abstract
BACKGROUND AND AIMS: To investigate the antiviral efficacy of combination therapy with Peg-IFNα-2a and ribavirin (RBV) in hepatitis C patients with liver cirrhosis after splenectomy or partial splenic embolization.
METHODS: Forty-nine hepatitis C patients with liver cirrhosis who were unable to use antiviral therapy because of hypersplenism were recruited for study and treated with splenectomy or partial splenic embolization.Three months later,a regimen of antiviral combination therapy was initiated with peg-IFNα -2a (once-weekly subcutaneous injection:135μg or 180μg) and RBV (daily oral:800~1200 mg),and was maintained for 48 weeks. The patients were followed up at treatment weeks 1,2,4,6,8,and 12.There after,follow-up was conducted every four weeks.The patients were observed until 24 weeks after treatment discontinuation.Follow-up testing included liver function,blood chemistry,renal function,and HCV RNA level.Any adverse reactions were recorded.
RESULTS: Hepatitis C Liver cirrhosis patients complicated by hypersplenism can be treated effectively with peg-IFNα -2a/RBV combination antiviral therapy after splenectomy or partial splenic embolization.The antiviral-induced sustained viral response rates was 65.00％in cirrhotic/hypersplenic hepatitis C patients receiving splenectomy and 58.62％ in those receiving partial splenic embolization.
CONCLUSIONS: Hypersplenism patients with hepatitis C-related cirrhosis achieved a good antiviral therapeutic effect with peg-IFNα 2a/RBV combination therapy following splenectomy or partial splenic embolization.This sequence of treatment may help to decrease incidences of chronic hepatitis C-induced liver failure and liver cancer in these patients.
