Long-term surveillance of liver histological changes in chronic hepatitis C patients completing pegylated interferon-α plus ribavirin therapy: an observational cohort study

被引：1

作者：

Hsieh, Ming-Han ^{[1
]}

Kao, Tzu-Yu ^{[3
]}

Hsieh, Ting-Hui ^{[4
]}

Kao, Chun-Chi ^{[2
]}

Peng, Cheng-Yuan ^{[1
]}

Lai, Hsueh-Chou ^{[2
]}

Chuang, Po-Heng ^{[2
]}

Kao, Jung-Ta ^{[1
,2
]}

机构：

[1] China Med Univ, Sch Med, Dept Med, 91 Hsueh Shih Rd, Taichung 40402, Taiwan

[2] China Med Univ Hosp, Div Gastroenterol & Hepatol, Dept Internal Med, Taichung, Taiwan

[3] Wroclaw Med Univ, Fac Med, Wroclaw, Dolnoslaskie, Poland

[4] Natl Yang Ming Chiao Tung Univ, Interdisciplinary Program Undergrad, Taipei, Taiwan

来源：

THERAPEUTIC ADVANCES IN CHRONIC DISEASE | 2022年 / 13卷

关键词：

chronic hepatitis C; fibrosis; liver biopsy; necroinflammatory activity; pegylated interferon-alpha; ribavirin; sustained virological response; DENSITY-LIPOPROTEIN RECEPTOR; CLINICAL-SIGNIFICANCE; SUSTAINED RESPONSE; FIBROSIS; REPLICATION; FETOPROTEIN; EXPRESSION; IMPROVEMENT; INHIBITION; AFP;

D O I：

10.1177/20406223211067631

中图分类号：

R9 [药学];

学科分类号：

1007 ;

摘要：

Background: For chronic hepatitis C (CHC) patients completing pegylated interferon (PegIFN)-alpha/ribavirin therapy, long-term liver histological changes remain largely unexplored. Methods: This observational cohort study included 85 CHC patients completing PegIFN-alpha/ribavirin therapy with liver biopsies performed at baseline and the end of surveillance (EOS). Median years between paired biopsies were 6.75 (interquartile range: 5.63-7.54). Results: In patients with baseline METAVIR fibrosis stages (F) <4 (able to undergo fibrosis progression; n=77), cases achieving sustained virological response (SVR) (n=52) had a significantly lower rate of fibrosis progression than non-SVR cases (n=25) (3.8% versus 24.0%, p= 0.012). Among the entire cohort (n=85), the rate of activity response [METAVIR activity grades (A) decreasing or maintaining at A0] in SVR cases (n=59) was significantly higher than that in non-SVR cases (n=26) (94.9% versus 65.4%, p=0.001). For SVR cases among the entire cohort, independent predictors of fibrosis clearance included baseline F <2 [odds ratio (OR)=7.877, p=0.042] and aspartate transaminase (AST) levels declining by >70% at EOS compared with baseline (OR=9.013, p= 0.038). For non-SVR cases among the entire cohort, baseline AST levels >80 U/l and glucose levels <= 105 mg/dl independently predicted significant fibrosis (F2/F3/F4) at EOS (OR=12.558, p= 0.049) and activity response (OR =17.741, p=0.047), respectively. Conclusions: Among CHC patients completing PegIFN-alpha/ribavirin therapy, SVR lowers the risk of liver histological progression but does not guarantee fibrosis clearance. For SVR cases, those with baseline F >= 2 or without significantly declined follow-up AST levels should be specifically monitored. As for non-SVR cases, those with a higher baseline AST or glucose level should preferentially receive retreatment.

引用

页数：18

共 35 条

[1] Histological response in patients treated by interferon plus ribavirin for hepatitis C virus-related severe fibrosis [J].