Differences in viral kinetics between genotypes 1 and 3 of hepatitis C virus and between cirrhotic and non-cirrhotic patients during antiviral therapy
Differences in viral kinetics between genotypes 1 and 3 of hepatitis C virus and between cirrhotic and non-cirrhotic patients during antiviral therapy
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DOI：
10.3748/wjg.v12.i45.7271
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发表时间：
2006-12-07
影响因子：
4.3
通讯作者：
Carrilho, Flair Jose
中科院分区：
文献类型：
--
作者：
Medeiros-Filho, Jose Eymard;Guedes de Carvalho Mello, Isabel Maria Vicente;Carrilho, Flair Jose
目的：评估基因1型或3型丙型肝炎病毒（HCV）感染以及是否存在肝硬化（LC）对早期治疗病毒动力学反应的影响。方法：对46例接受干扰素- α (ifn - α)和利巴韦林治疗并随访频繁进行早期HCV-RNA检测的患者进行分析。患者感染基因1型（28,7例LC）或基因3型（18,5例LC）。结果：基因3型患者的一期下降幅度大于基因1型患者（1.72 vs 0.95 log IU/mL, P < 0.001）。基因3型患者的二期斜率下降也大于基因1型患者（0.87 vs 0.15 log/wk, P < 0.001）。在肝硬化和非肝硬化患者中均发现差异。基因1型肝硬化患者的2(d)期斜率比非肝硬化患者慢（0.06 vs 0.18 log/wk, P < 0.02）。没有1型肝硬化患者的1（st）期下降大于1 log（非肝硬化患者：55%，P < 0.02）。在基因3型肝硬化患者中观察到类似的第2(2)期斜率下降趋势，但第1(1)期斜率下降没有区别，基因3型患者的持续病毒反应高于基因1型患者（72%对14%，P < 0.001），基因I型非肝硬化患者的持续病毒反应高于基因1型肝硬化患者（19%对0%）。在所有组中，第二阶段下降速度低于每周0.3 log是无反应的预测。结论：基因3型比基因1型有更快的早期病毒衰退。在基因1型患者中，肝硬化与较慢的第2(2)期下降相关，并且可能与较低的第1期斜率下降相关。(c) 2006年WJG出版社。版权所有。
AIM: To evaluate the impact of hepatitis C virus (HCV) infection with genotype 1 or 3 and the presence or absence of liver cirrhosis (LC) in the early viral kinetics response to treatment.METHODS: Naive patients (n = 46) treated with interferon-alpha (IFN-alpha) and ribavirin and followed up with frequent early HCV-RNA determinations were analysed. Patients were infected with genotype 1 (n = 28, 7 with LC) or 3 (n = 18, 5 with LC).RESULTS: The first phase decline was larger in genotype 3 patients than in genotype 1 patients (1.72 vs 0.95 log IU/mL, P < 0.001). The second phase slope decline was also larger in genotype 3 patients than in genotype 1 patients (0.87 vs 0.15 log/wk, P < 0.001). Differences were found in both cirrhotic and non-cirrhotic patients. Genotype 1 cirrhotic patients had a slower 2(nd) phase slope than non-cirrhotic patients (0.06 vs 0.18 log/wk, P < 0;02). None of genotype 1 cirrhotic patients had a 1(st) phase decline larger than 1 log (non-cirrhotic patients: 55%, P < 0.02). A similar trend toward a slower 2(nd) phase slope was observed in genotype 3 cirrhotic patients but the 1(st) phase slope decline was not different, Sustained viral response was higher in genotype 3 patients than in genotype 1 patients (72% vs 14%, P < 0.001) and in genotype I non-cirrhotic patients than in genotype I cirrhotic patients (19% vs 0%). A second phase decline slower than 0.3 log per week was predictive of non-response in all groups.CONCLUSION: Genotype 3 has faster early viral decline than genotype 1. Cirrhosis correlates with a slower 2(nd) phase decline and possibly with a lower 1st phase slope decline in genotype 1 patients. (c) 2006 The WJG Press. All rights reserved.