Durability of a sustained virological response, late clinical sequelae, and long-term changes in aspartate aminotransferase to the platelet ratio index after successful treatment with peginterferon/ribavirin for chronic hepatitis C: a prospective study
Durability of a sustained virological response, late clinical sequelae, and long-term changes in aspartate aminotransferase to the platelet ratio index after successful treatment with peginterferon/ribavirin for chronic hepatitis C: a prospective study
复制标题
DOI：
10.1097/meg.0b013e32835eb8bf
复制
发表时间：
2013-07-01
影响因子：
2.1
通讯作者：
Karatapanis, Stylianos
中科院分区：
文献类型：
--
作者：
Papastergiou, Vasilios;Stampori, Maria;Karatapanis, Stylianos
以往的研究，主要是使用传统干扰素的回顾性研究，表明慢性丙型肝炎患者预后良好，并有持续的病毒学反应（SVR）。然而，在聚乙二醇化干扰素（PegIFN）时代，SVR患者的长期预后，包括肝纤维化程度的变化，仍然不明确。我们对伴有SVR的慢性丙型肝炎患者的长期病毒学、临床和生化结果进行了前瞻性评估，包括天冬氨酸转氨酶与血小板比值指数（APRI）。患者和方法我们纳入了145例连续的、未接受治疗的慢性丙型肝炎患者（平均年龄47.3±9.1岁；男性87例；42.1%基因型1；36.6%基因型2/3），这些患者在联合PegIFN-/利巴韦林治疗后达到SVR。结果平均随访时间为68.8±35个月。肝细胞癌（HCC）和肝脏相关死亡的总发生率分别为1.4%和0.7%。在9例（7.6%）肝硬化预处理患者中，2例（22.2%）发生HCC， 1例（11.1%）死亡。没有患者有晚期病毒学复发的确凿证据。145例患者中有5例（3.5%）转氨酶水平持续升高，所有患者均被诊断为新的肝脏疾病，所有患者的肝脏生化指标均保持正常。APRI值随治疗显著提高(0.95 +/- 1.09 vs. 0.66 +/- 0.64， P
Objectives Previous studies, mostly retrospective using conventional interferon, have suggested a favorable prognosis for patients with chronic hepatitis C and a sustained virological response (SVR). However, long-term outcome, including changes in the degree of hepatic fibrosis, of SVR patients in the era of pegylated interferon (PegIFN) remains underdefined. We prospectively evaluated the long-term virological, clinical, and biochemical outcomes, including aspartate aminotransferase-to-platelet ratio index (APRI), in chronic hepatitis C patients with an SVR.Patients and methods We included 145 consecutive, treatment-naive chronic hepatitis C patients (mean age 47.3 +/- 9.1 years; 87 men; 42.1% genotype 1; 36.6% genotype 2/3) who achieved an SVR after combination therapy with PegIFN-/ribavirin.Results The mean follow-up time was 68.8 +/- 35 months. The overall incidence of hepatocellular carcinoma (HCC) and liver-related death was 1.4 and 0.7%, respectively. Among nine (7.6%) patients with pretreatment cirrhosis, two (22.2%) developed HCC and one of them (11.1%) died. No patient had conclusive evidence of late virological relapse. All patients retained normal liver biochemistry, except for five of 145 (3.5%), who had persistently elevated transaminase levels, all of whom were diagnosed with new liver disease. APRI values improved significantly with treatment (0.95 +/- 1.09 vs. 0.66 +/- 0.64, P