Durability of Sustained Virologic Response in Chronic Hepatitis C
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background/Aims: The aim of this study is to investigate the rate of sustained virologic response (SVR) in chronic hepatitis C patients receiving antiviral treatment. Methods:The files of patients with chronic hepatitis C treated with interferon±ribavirin between 1995 and 2009 were reviewed retrospectively. Six months after the end of treatment, patients with negative hepatitis C virus (HCV)-RNA (<50 IU/mL,as determined by the polymerase chain reaction method)were enrolled in the study. Results: The mean age of 196patients (89 males) was 46.13±11.10 years (range, 17 to 73 years). In biopsies, the mean stage was 1.50±0.94; histological activity index was 7.18±2.43. In total, 139 patients received pegylated interferon (IFN)+ribavirin, 21 patients received classical IFN+ribavirin, and 36 patients received IFN alone. The HCV genotypes of 138 patients were checked:77.5% were genotype 1b, and 22.5% were other genotypes. After achievement of SVR, the median follow-up period was 33.5 months (range, 6 to 112 months), and in this period relapse was only detected in two patients (1.02%) at 18 and 48 months after treatment. Conclusions: In total, 98.9% of patients with SVR in chronic hepatitis C demonstrated truly durable responses over the long-term follow-up period of 3years; relapsed patients had intermittent or low-grade viremia.
Abstract
Background/Aims: The aim of this study is to investigate the rate of sustained virologic response (SVR) in chronic hepatitis C patients receiving antiviral treatment. Methods:The files of patients with chronic hepatitis C treated with interferon±ribavirin between 1995 and 2009 were reviewed retrospectively. Six months after the end of treatment, patients with negative hepatitis C virus (HCV)-RNA (<50 IU/mL,as determined by the polymerase chain reaction method)were enrolled in the study. Results: The mean age of 196patients (89 males) was 46.13±11.10 years (range, 17 to 73 years). In biopsies, the mean stage was 1.50±0.94; histological activity index was 7.18±2.43. In total, 139 patients received pegylated interferon (IFN)+ribavirin, 21 patients received classical IFN+ribavirin, and 36 patients received IFN alone. The HCV genotypes of 138 patients were checked:77.5% were genotype 1b, and 22.5% were other genotypes. After achievement of SVR, the median follow-up period was 33.5 months (range, 6 to 112 months), and in this period relapse was only detected in two patients (1.02%) at 18 and 48 months after treatment. Conclusions: In total, 98.9% of patients with SVR in chronic hepatitis C demonstrated truly durable responses over the long-term follow-up period of 3years; relapsed patients had intermittent or low-grade viremia.
참고문헌 (22)
- Marcellin P, "Long-term histologic improvement and loss of detectable intrahepatic HCV RNA in patients with chronic hepatitis C and sustained response to interferon-alpha therapy", Ann Intern Med, 127, pp.875~881 (1997)
- Poynard T, "Meta-analysis of interferon randomized trials in the treatment of viral hepatitis C: effects of dose and duration", Hepatology, 24, pp.778~789 (1996)
- Thevenot T, "Meta-analysis of interferon randomized trials in the treatment of viral hepatitis C in naive patients: 1999 update", J Viral Hepat, 8, pp.48~62 (2001)
- Hadziyannis SJ, "Peginterferon-alpha2a and ribavirin combination therapy in chronic hepatitis C: a randomized study of treatment duration and ribavirin dose", Ann Intern Med, 140, pp.346~355 (2004)
- Strader DB, "American Association for the Study of Liver Diseases. Diagnosis, management, and treatment of hepatitis C", Hepatology, 39, pp.1147~1171 (2004)
- Myers RP, "The rate of fibrosis progression is an independent predictor of the response to antiviral therapy in chronic hepatitis C", J Viral Hepat, 10, pp.16~22 (2003)
- Serra MA, "Influence of age and date of infection on distribution of hepatitis C virus genotypes and fibrosis stage", J Viral Hepat, 10, pp.183~188 (2003)
- Arase Y, "Randomized trial of prolonged interferon retreatment for chronic hepatitis C patients with HCV-genotype 1b and high virus load", Hepatol Res, 25, pp.364~370 (2003)
- Veldt BJ, "Long term clinical outcome of chronic hepatitis C patients with sustained virological response to interferon monotherapy", Gut, 53, pp.1504~1508 (2004)
- Sobesky R, "Pathological evolution of hepatitis C virus-”Healthy carriers”", World J Gastroenterol, 14, pp.3861~3865 (2008)
- Maylin S, "Sustained virological response is associated with clearance of hepatitis C virus RNA and a decrease in hepatitis C virus antibody", Liver Int, 29, pp.511~517 (2009)
- Schvarcz R, "Histological and virological long-term outcome in patients treated with interferon-alpha2b and ribavirin for chronic hepatitis C", J Viral Hepat, 6, pp.237~242 (1999)
- Tsuda N, "Long-term clinical and virological outcomes of chronic hepatitis C after successful interferon therapy", J Med Virol, 74, pp.406~413 (2004)
- Lau DT, "10-Year follow-up after interferon-alpha therapy for chronic hepatitis C", Hepatology, 28, pp.1121~1127 (1998)
- Maylin S, "Eradication of hepatitis C virus in patients successfully treated for chronic hepatitis C", Gastroenterology, 135, pp.821~829 (2008)
- Soriano V, "Long-term follow-up of HIV-infected patients with chronic hepatitis C virus infection treated with interferon-based therapies", Antivir Ther, 9, pp.987~992 (2004)
- Swain M, "Durability of sustained virological response (SVR) after treatment with peginterferon alfa-2a (40kd) (pegasysb) alone or in combination with ribavirin (copegusm): results of an ongoing long-term follow-up study", Hepatology, 40(Suppl 4), pp.400A~ (2004)
- McHutchison JG, "Hepatic HCV RNA before and after treatment with interferon alone or combined with ribavirin", Hepatology, 35, pp.688~693 (2002)
- Radkowski M, "Persistence of hepatitis C virus in patients successfully treated for chronic hepatitis C", Hepatology, 41, pp.106~114 (2005)
- Yoshida H, "Benefit of interferon therapy in hepatocellular carcinoma prevention for individual patients with chronic hepatitis C", Gut, 53, pp.425~430 (2004)
- Shiratori Y, "Histologic improvement of fibrosis in patients with hepatitis C who have sustained response to interferon therapy", Ann Intern Med, 132, pp.517~524 (2000)
- Neary MP, "Sustained virologic response is associated with improved health-related quality of life in relapsed chronic hepatitis C patients", Semin Liver Dis, 1(19 Suppl 1), pp.77~85 (1999)