Hepatic steatosis has no impact on the outcome of treatment in patients with chronic hepatitis B infection
Hepatic steatosis has no impact on the outcome of treatment in patients with chronic hepatitis B infection
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DOI：
10.1097/01.mcg.0000225586.78330.60
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发表时间：
2007-05-01
影响因子：
2.9
通讯作者：
Unal, Selahattin
中科院分区：
文献类型：
--
作者：
Cindoruk, Mehmet;Karakan, Tarkan;Unal, Selahattin
背景：肝脂肪变性作为治疗结果的预测因素，在慢性乙型肝炎（CHB）中未被研究。本回顾性分析的目的是确定肝脂肪变性与慢性乙型肝炎患者治疗反应之间可能的关系。方法：对140例慢性乙型肝炎患者[乙型肝炎e抗原（HBeAg）阳性42例，HBeAg阴性98例]进行分析。78例（55.7%）患者接受聚乙二醇化干扰素α 2a 180 μ g/周皮下注射，62例（44.3%）患者接受聚乙二醇化干扰素α 2a 180 μ g/周加拉米夫定100 mg/d联合治疗。结果：脂肪变性与体重指数升高和高脂血症有关。hbeag阴性患者的持续病毒学应答率（SVR）在有脂肪变性和无脂肪变性患者中分别为36.2%和31.5% （P < 0.05）。hbeag阳性患者和非脂肪变性患者的SVR分别为39.6%和33.3% （P < 0.05）。肝脂肪变性的患病率对两组的治疗结果没有显著影响。聚乙二醇化干扰素单药治疗组（1组）SVR为18/78(23%)，聚乙二醇化干扰素联合拉米夫定联合治疗组（2组）SVR为16/62 (26%),P < 0.05, NS >。影响治疗结果的独立因素是较高的基线丙氨酸转氨酶水平和较低的基线病毒载量。结论：脂肪变性是慢性乙型肝炎感染的一个常见现象；然而，它与病毒载量和治疗结果无关。
Background: Hepatic steatosis, as a predictive factor in treatment outcome, was not investigated in chronic hepatitis B (CHB). The aim of this retrospective analysis is to determine possible relationships between hepatic steatosis and treatment response in patients with CHB. Methods: One hundred forty patients with CHB [42 hepatitis B e antigen (HBeAg)-positive, 98 HBeAg-negative] were analyzed. Seventy-eight patients (55.7%) received pegylated interferon a 2a 180 mu g/wk subcutaneously and 62 patients (44.3%) received pegylated interferon alpha 2a 180 mu g/wk plus lamivudine 100 mg/d combination therapy. Results: The presence of steatosis was associated with increased body mass index and hyperlipidemia. The sustained virologic response (SVR) rates in HBeAg-negative patients were 36.2% and 31.5% in patients with and without steatosis, respectively (P > 0.05). The SVR rates in HBeAg-positive patients were 39.6% and 33.3% in patients with and without steatosis, respectively (P > 0.05). The prevalence of hepatic steatosis did not significantly affect the outcome of treatments in both groups. In pegylated interferon monotherapy group (group 1), SVR was 18/78 (23%) and in the pegylated interferon plus lamivudine combination group (group 2) SVR was 16/62 (26%), (P > 0.05, NS). The independent factors affecting the treatment outcome were higher baseline alanine aminotransferase level and lower baseline viral load. Conclusions: The prevalence of steatosis is a common finding in CHB infection; however, it is not associated with viral load and treatment outcome.