Surprisingly small effect of antiviral treatment in patients with hepatitis C
Surprisingly small effect of antiviral treatment in patients with hepatitis C
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DOI：
10.7326/0003-4819-136-4-200202190-00008
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发表时间：
2002-02-19
影响因子：
39.2
通讯作者：
McCullough, AJ
中科院分区：
文献类型：
--
作者：
Falck-Ytter, Y;Kale, H;McCullough, AJ
背景资料：干扰素为基础的抗病毒治疗在丙型肝炎病毒（HCV）感染人群中的效果和适用性尚不清楚。目的：确定抗病毒治疗在大都市诊所人群中的适用性和有用性。设计：连续转诊患者的回顾性病例系列。设置：俄亥俄州克利夫兰的一所教学县医院。患者：327例患者在酶联免疫吸附试验（ELISA）上HCV抗体阳性后被转诊至肝脏诊所。测量：治疗率;未治疗的原因。结果：34例患者未检测到HCV RNA。在其余293例患者中，72%因以下原因未接受治疗：37%未遵守评估程序，34%有医学或精神病禁忌症，13%有持续的物质或酒精滥用，11%不喜欢治疗，5%肝酶水平正常。只有83例（28%）进行了治疗，13%有持续的病毒respons.Conclusion：大多数HCV感染的患者是不是候选人干扰素为基础的治疗，替代干预措施应寻求这些患者。
Background: The effect and applicability of interferon-based antiviral therapies in the general population of persons with hepatitis C virus (HCV) infection are unknown.Objective: To determine the applicability and usefulness of antiviral therapy in a metropolitan clinic population.Design: Retrospective case series of consecutively referred patients.Setting: A teaching county hospital in Cleveland, Ohio.Patients: 327 patients referred to a liver clinic after a positive result for antibody against HCV on enzyme-linked immunosorbent assay (ELISA).Measurements: Treatment rates; reasons for nontreatment.Results: 34 patients had no detectable HCV RNA. Of the remaining 293 patients, 72% were not treated for the following reasons: 37% did not adhere to evaluation procedures, 34% had medical or psychiatric contraindications, 13% had ongoing substance or alcohol abuse, 11% preferred no treatment, and 5% had normal liver enzyme levels. Only 83 patients (28%) were treated; 13% had a sustained viral response.Conclusion: Most patients with HCV infection are not candidates for interferon-based therapies; alternative interventions should be sought for these patients.