J Gastroenterol Hepatol:采用无干扰素治疗方案治疗1天后,患者血清HCV-RNA水平降低的临床意义

2018-06-10 MedSci MedSci原创

HCV患者采用无干扰素治疗方案治疗1天后,患者血清HCV-RNA水平降低程度与治疗24周患者的治疗结果没有相关性;但是,在接受12周治疗方案的患者中,血清HCV-RNA水平的降低与SVR相关,HCV-RNA载量减少预示着SVR的出现,因此有可能成为确定患者存在治疗失败风险的因素。

研究背景和目的:本研究旨在评估DAA治疗HCV患者的极早期病毒学反应的意义以及对治疗结果的影响。

研究方法:544例HCV患者在接受无干扰素治疗1天后,检测血清HCV RNA下降的程度。评估HCV RNA载量的减少和获得持续病毒学应答或未获得持续病毒学应答之间的相关性。

研究结果:除肝纤维化分期外,患者特征对第1天血清HCV-RNA减少无影响。接受24周方案治疗的SVR患者和未获得SVR患者的1天的HCVRNA载量减少没有差异。相比之下,在接受12周方案治疗的患者中,SVR患者的1天HCV RNA载量减少程度显著高于未获得SVR患者(P = 0.0013);1天的HCV RNA载量减少程度是预测患者是否可以获得SVR的预测因素(受试者-操作特征曲线下面积:0.80)。

研究结论:HCV患者采用无干扰素治疗方案治疗1天后,患者血清HCV-RNA水平降低程度与治疗24周患者的治疗结果没有相关性;但是,在接受12周治疗方案的患者中,血清HCV-RNA水平的降低与SVR相关,HCV-RNA载量减少预示着SVR的出现,因此有可能成为确定患者存在治疗失败风险的因素。

原始出处:

Toyoda H, Kumada T, Tada T, et al. Significance of day-1 viral response of hepatitis C virus in patients with chronic hepatitis C receiving direct-acting antiviral therapy. J Gastroenterol Hepatol, 2018, 33(6), 1264-1270.

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    2019-05-08 许安
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  5. [GetPortalCommentsPageByObjectIdResponse(id=2064420, encodeId=f8ec206442098, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Thu Apr 18 17:45:00 CST 2019, time=2019-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711522, encodeId=33e61e1152219, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sat Mar 23 18:45:00 CST 2019, time=2019-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072196, encodeId=7aa820e2196c1, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Wed May 08 23:45:00 CST 2019, time=2019-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1905061, encodeId=cbc4190506197, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Mon Jul 09 15:45:00 CST 2018, time=2018-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=323916, encodeId=344d32391618, content=很好的学习机会, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/12/cd30eefc465f70dc4dad89bd57479781.jpg, createdBy=02be2318568, createdName=一天没事干, createdTime=Wed Jun 13 20:18:08 CST 2018, time=2018-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257742, encodeId=43ba125e742ad, content=<a href='/topic/show?id=774e856e22' target=_blank style='color:#2F92EE;'>#HCV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8567, encryptionId=774e856e22, topicName=HCV)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=460849, createdName=ymljack, createdTime=Tue Jun 12 08:45:00 CST 2018, time=2018-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1427141, encodeId=5e38142e14153, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Tue Jun 12 08:45:00 CST 2018, time=2018-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=323105, encodeId=07453231056b, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Sun Jun 10 20:19:36 CST 2018, time=2018-06-10, status=1, ipAttribution=)]
    2018-06-13 一天没事干

    很好的学习机会

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2064420, encodeId=f8ec206442098, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Thu Apr 18 17:45:00 CST 2019, time=2019-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711522, encodeId=33e61e1152219, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sat Mar 23 18:45:00 CST 2019, time=2019-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072196, encodeId=7aa820e2196c1, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Wed May 08 23:45:00 CST 2019, time=2019-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1905061, encodeId=cbc4190506197, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Mon Jul 09 15:45:00 CST 2018, time=2018-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=323916, encodeId=344d32391618, content=很好的学习机会, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/12/cd30eefc465f70dc4dad89bd57479781.jpg, createdBy=02be2318568, createdName=一天没事干, createdTime=Wed Jun 13 20:18:08 CST 2018, time=2018-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257742, encodeId=43ba125e742ad, content=<a href='/topic/show?id=774e856e22' target=_blank style='color:#2F92EE;'>#HCV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8567, encryptionId=774e856e22, topicName=HCV)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=460849, createdName=ymljack, createdTime=Tue Jun 12 08:45:00 CST 2018, time=2018-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1427141, encodeId=5e38142e14153, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Tue Jun 12 08:45:00 CST 2018, time=2018-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=323105, encodeId=07453231056b, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Sun Jun 10 20:19:36 CST 2018, time=2018-06-10, status=1, ipAttribution=)]
    2018-06-12 ymljack
  7. [GetPortalCommentsPageByObjectIdResponse(id=2064420, encodeId=f8ec206442098, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Thu Apr 18 17:45:00 CST 2019, time=2019-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711522, encodeId=33e61e1152219, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sat Mar 23 18:45:00 CST 2019, time=2019-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072196, encodeId=7aa820e2196c1, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Wed May 08 23:45:00 CST 2019, time=2019-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1905061, encodeId=cbc4190506197, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Mon Jul 09 15:45:00 CST 2018, time=2018-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=323916, encodeId=344d32391618, content=很好的学习机会, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/12/cd30eefc465f70dc4dad89bd57479781.jpg, createdBy=02be2318568, createdName=一天没事干, createdTime=Wed Jun 13 20:18:08 CST 2018, time=2018-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257742, encodeId=43ba125e742ad, content=<a href='/topic/show?id=774e856e22' target=_blank style='color:#2F92EE;'>#HCV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8567, encryptionId=774e856e22, topicName=HCV)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=460849, createdName=ymljack, createdTime=Tue Jun 12 08:45:00 CST 2018, time=2018-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1427141, encodeId=5e38142e14153, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Tue Jun 12 08:45:00 CST 2018, time=2018-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=323105, encodeId=07453231056b, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Sun Jun 10 20:19:36 CST 2018, time=2018-06-10, status=1, ipAttribution=)]
    2018-06-12 gwc384
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    2018-06-10 天地飞扬

    了解一下.谢谢分享!

    0

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J Viral Hepat:埃及丙型肝炎患者采用DAA治疗后,肝癌复发率增加

研究结果表明为DAAs在HCC复发中的可能作用提供了重要的证据,并强调需要进一步的机制研究和临床试验来准确地确认这一角色,并确定可能与该事件相关的患者特征。

Liver Int:对采用以daclatasvir为基础治疗方案的HCV患者,进行长期随访

99%的接受daclatasvira治疗方案的患者,获得SVR12。肝病进展和新的肝细胞癌并不常见。

Eur J Gastroenterol Hepatol:在意大利口服直接抗病毒治疗时代之前,丙型肝炎病毒相关慢性肝病患者的特点

在意大利,慢性丙型肝炎病毒感染在CLD中起着越来越小的作用,显示出向老年群体和更严重的疾病阶段转移。这些数据,与DAA治疗之前相关,是评估DAAs在未来有效性的最新参考数据。

Eur J Gastroenterol Hepatol:DAA治疗前后,肝硬度和肝脂肪变性的变化

SVR24的肝硬度可能能够反映接受DAA治疗的患者的肝纤维化情况。另外,脂肪肝减少的同时,肝脂肪变性也减少了。

BMC Infect Dis:乙型肝炎和丙型肝炎患者死亡率趋势:以人口为基础的联系研究,1993-2012

HBV相关的肝脏死亡率的降低和负担的稳定,表明了抗病毒治疗效果的影响。与此相反,针对HCV的干扰素治疗方案对肝脏相关死亡率、个体水平风险和人口水平负担的影响是有限的。

J Gastroenterol Hepatol:HCV、HBV双感染阻断了血小板计数的恢复,尤其是在晚期肝纤维化患者中

丙型肝炎病毒根除后血小板计数恢复。HBV双感染阻断了PLT计数的恢复,尤其是在晚期肝纤维化患者中。