Perihepatic lymph node enlargement is a negative predictor for sustained responses to pegylated interferon-α and ribavirin therapy for Japanese patients infected with hepatitis C virus genotype 1.
Perihepatic lymph node enlargement is a negative predictor for sustained responses to pegylated interferon-α and ribavirin therapy for Japanese patients infected with hepatitis C virus genotype 1.
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肝周淋巴结肿大是感染丙型肝炎病毒基因型 1 的日本患者对聚乙二醇干扰素 α 和利巴韦林治疗持续反应的阴性预测因子。
DOI：
10.1111/hepr.12061
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发表时间：
2013
期刊：
影响因子：
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通讯作者：
Yoshida H et al. (16人中4番目)
中科院分区：
文献类型：
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作者：
Zhang XH;Sho R;Watanabe H;et al;Yoshida H et al. (16人中4番目)
目的：尽管肝周淋巴结肿大（PLNE）与干扰素治疗慢性丙型肝炎的负面结果相关，但其局限性在于该结果是在不同基因型、病毒载量和治疗方案的患者中获得的。本研究旨在明确PLNE在干扰素治疗慢性丙型肝炎中的意义。方法在2004年12月至2005年6月期间，纳入了112例基因型1型丙型肝炎病毒（HCV）和HCV RNA超过100 KIU/mL的患者，随后接受聚乙二醇化干扰素α加利巴韦林治疗。超声检查将肝周淋巴结定义为长轴大于1cm的淋巴结。结果PLNE患者的持续病毒学应答（SVR）率（4/22,18.2%）低于未感染PLNE患者（37/90,41.1%，P= 0.045），病毒载量下降幅度小于未感染PLNE患者（P= 0.028）。按治疗结果分组的患者中，SVR组PLNE阳性患者比例最小（P= 0.033）。通过多因素logistic回归分析，PLNE仍然是SVR的负预测因子（P= 0.012）。此外，在2011年12月至2012年3月登记的45例1型HCV患者中，PLNE与HCV核心蛋白、干扰素敏感性决定区或白细胞介素28B多态性的突变没有显著相关性。结论plne是HCV基因型1和HCV RNA大于100 KIU/mL的患者接受聚乙二醇化干扰素α +利巴韦林治疗的SVR的阴性预测因子，独立于其他已知的SVR预测因子。
AimAlthough perihepatic lymph node enlargement (PLNE) is reportedly associated with the negative outcome of interferon therapy for chronic hepatitis C, there were limitations in that the results were obtained in patients with various genotypes, viral loads and treatment regimens. We aimed to precisely clarify the significance of PLNE in interferon therapy for chronic hepatitis C.MethodsBetween December 2004 and June 2005, 112 patients with hepatitis C virus (HCV) genotype 1 and HCV RNA of more than 100 KIU/mL were enrolled, who underwent pegylated interferon‐α plus ribavirin therapy thereafter. PLNE was defined as a perihepatic lymph node of more than 1 cm in the longest axis by ultrasonography.ResultsThe sustained virological response (SVR) rate was lower in patients with PLNE (4/22, 18.2%) than in those without (37/90, 41.1%;P= 0.045) and viral load decline was smaller in patients with PLNE than in those without (P= 0.028). The proportion of PLNE positive patients was the smallest in the SVR group (P= 0.033) among the patient groups divided by the treatment outcome. PLNE was retained as a negative predictor for SVR by multivariate logistic regression analysis (P= 0.012). Furthermore, PLNE was not significantly associated with the mutations at HCV core protein and at interferon sensitivity‐determining region, or interleukin‐28B polymorphism in 45 patients with HCV genotype 1, enrolled between December 2011 and March 2012.ConclusionPLNE is a negative predictor for SVR in patients with HCV genotype 1 and HCV RNA of more than 100 KIU/mL treated with pegylated interferon‐α plus ribavirin, independent of other known predictors for SVR.