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首页> 外文期刊>Alimentary pharmacology & therapeutics. >Sustained virological responses following standard anti-viral therapy in decompensated HCV-infected cirrhotic patients.
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Sustained virological responses following standard anti-viral therapy in decompensated HCV-infected cirrhotic patients.

机译:在失代偿的HCV感染的肝硬化患者中,标准抗病毒治疗后持续的病毒学应答。

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摘要

BACKGROUND: Little data is available about predictors of sustained virological response (SVR) during anti-viral therapy of patients with decompensated HCV cirrhosis. AIMS: To determine whether rapid and early virological responses (RVR and EVR) could predict SVR and help optimize treatment in these patients. METHODS: A total of 94 cirrhotics underwent treatment with peg-interferon alfa-2b (1.5 microg/kg weekly) and ribavirin (800/1200 mg daily) for 48 or 24 weeks for genotypes 1/4 or genotypes 2/3, respectively. RESULTS: Overall, SVR was achieved in 33 patients (35.1%), 16% with genotype 1/4 and 56.8% with genotype 2/3 (P < 0.01). At treatment week 4, 34 patients had undetectable HCV-RNA, 10 with genotype 1/4 and 24 with genotype 2/3. Of RVR patients, 24 achieved SVR (70.5%), 6 and 18 with genotypes 1 and non-1. At the multivariate analysis, only EVR, genotypes 2 and 3, and adherence to full course and dosage of therapy retained their independent predictive power, with corresponding ORs of 25.5 (95% CI 3.0-217.3), 4.2 (95% CI 1.2-15.3) and 9.1 (95% CI 2.2-38.0), respectively. CONCLUSION: In decompensated cirrhotic patients, anti-viral therapy with current regimens is feasible and associated with an overall SVR rate of 35.1%. Treatment ought to be pursued among patients who attain an EVR, and maintain a full course and dosage of therapy.
机译:背景:关于代偿性HCV肝硬化患者抗病毒治疗期间持续病毒学应答(SVR)的预测因子的数据很少。目的:确定快速和早期病毒学应答(RVR和EVR)是否可以预测SVR并帮助优化这些患者的治疗。方法:分别用聚乙二醇干扰素α-2b(每周1.5微克/千克)和利巴韦林(每天800/1200毫克)治疗94例肝硬化患者,分别治疗基因型1/4或基因型2/3。结果:总体上,SVR达到33例(35.1%),基因型为1/4的患者为16%,基因型为2/3的56.8%(P <0.01)。在治疗的第4周,有34例患者的HCV-RNA检测不到,其中有1/4基因型的患者10例,而2/3基因型的患者24例。在RVR患者中,有24位达到SVR(70.5%),基因型1和非1的6和18。在多变量分析中,只有EVR,基因型2和3以及坚持全疗程和治疗剂量可以保持其独立的预测能力,相应的OR分别为25.5(95%CI 3.0-217.3),4.2(95%CI 1.2-15.3) )和9.1(95%CI 2.2-38.0)。结论:在失代偿性肝硬化患者中,采用当前方案进行抗病毒治疗是可行的,且总SVR率为35.1%。获得EVR并维持完整疗程和治疗剂量的患者应寻求治疗。

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