Spontaneous Weight Change during Chronic Hepatitis C Treatment: Association with Virologic Response Rates
Spontaneous Weight Change during Chronic Hepatitis C Treatment: Association with Virologic Response Rates
复制标题
DOI：
10.7150/ijms.6184
复制
发表时间：
2013-01-01
影响因子：
3.6
通讯作者：
Kandil, Hossam M.
中科院分区：
文献类型：
--
作者：
Alwakeel, Hany R.;Zaghla, Hasan E.;Kandil, Hossam M.
目的：研究慢性丙型肝炎（CHC）治疗期间体重变化及其与病毒学反应的关系。方法：比较获得快速、早期和持续病毒学应答率（RVR、EVR和SVR）的受试者的体重变化。在4、12、48周比较体重减轻或未体重减轻的>= 0.5体重指数（BMI）单位（kg/m(2)）患者的RVR、EVR和SVR。结果：184例患者接受CHC治疗。预处理BMI中位数为27.7(18.4-51.3)，其中超重38%，肥胖31% （BMI分别为25和30）。在肝活检患者（n = 90）中，31.6%存在脂肪变性；纤维化等级为1-2/6的占46%，3-4的占37.3%，5-6的占14.7%。治疗4周、12周、24周和48周的平均体重减轻分别为1.2、2.6、3.8和3.3 kg。治疗4周和12周后，38%和54.3%的患者BMI下降>= 0.5 kg/m(2)。对于基因型1,4周体重减轻与较高的EVR （90.0% vs 70%, p = 0.01）以及较好的RVR和SVR（分别为42.9% vs. 26.0%和55.2% vs. 34.8%, p = 0.08）相关。在多变量分析中，4周时体重减轻与EVR独立相关（OR 6.3, p = 0.02），但与RVR或svr无显著相关性。结论：CHC治疗4周和12周时自发体重减轻与EVR改善相关。4周体重减轻是EVR的独立预测因子，但不是SVR。
Objective: We examined weight changes during chronic hepatitis C (CHC) therapy and association with virologic response.Methods: Weight changes were compared between subjects achieving rapid, early, and sustained virologic response rates (RVR, EVR, and SVR). RVR, EVR and SVR were compared among patients with or without weight loss of >= 0.5 body mass index (BMI) units (kg/m(2)) at 4, 12, 48 weeks.Results: CHC therapy was initiated in 184 cases. Median pretreatment BMI was 27.7 (18.4-51.3) with 38% overweight and 31% obese (BMI = 25 and = 30, respectively). Among patients with liver biopsies (n = 90), steatosis was present in 31.6%; fibrosis grade of 1-2/6 in 46%, 3-4 in 37.3% and 5-6 in 14.7%. Mean weight loss at 4, 12, 24 and 48 weeks of therapy were 1.2, 2.6, 3.8 and 3.3 kg, respectively. After 4 and 12 weeks of treatment, 38% and 54.3% had a BMI decrement of >= 0.5 kg/m(2). For genotype 1, weight loss at 4 weeks was associated with significantly higher EVR (90.0% vs. 70%, p = 0.01) and a tendency towards better RVR and SVR (42.9% vs. 26.0% and 55.2% vs. 34.8%, respectively, p = 0.08). In multivariate analysis, weight loss at 4 weeks was independently associated with EVR (OR 6.3, p = 0.02) but was not significantly associated with RVR or SVRConclusions: Spontaneous weight loss at 4 and 12 weeks of CHC therapy was associated with improved EVR. Weight loss at 4 weeks was an independent predictor of EVR but not SVR.