慢性D型肝炎患者干扰素治疗持续时间及其对自然病程的影响

StephenW

Interferon Treatment Duration in Patients With Chronic Delta Hepatitis and its Effect on the Natural Course of the Disease
Cihan Yurdaydin Onur Keskin Çağdaş Kalkan Fatih Karakaya Aysun Çalişkan Gökhan Kabaçam F Oğuz Önder Senem Karatayli Ersin Karatayli Xheni Deda ... Show more
The Journal of Infectious Diseases, jix656, https://doi.org/10.1093/infdis/jix656
Published:
07 February 2018

Abstract
Background

Interferon is the only treatment option in chronic delta hepatitis (CDH). A CDH database (333 patients, 161 with interferon treatment history) was analyzed for effects of treatment duration on virologic response and clinical outcomes.
Methods

Ninety-nine CDH patients who received at least 6 months of interferon were selected. Maintained virologic response (MVR) was defined as hepatitis D virus RNA negative for 2 years after treatment discontinuation. Cumulative median interferon treatment duration was 24 months (range 6–126 months), with a median of 2 courses (range 1–8). Post-treatment median follow-up was 55 months (24–225 months).
Results

Thirty-five patients achieved MVR. Cumulative probability of MVR increased with treatment duration and reached 50% at 5 years. Patients with MVR were less likely to die from liver disease or develop complications compared to patients without MVR (P = .032, P = .006, respectively). Cirrhosis at baseline and no response to therapy (odds ratio 16.1 and 5.23, respectively) predicted an adverse endpoint. Hepatitis B surface antigen clearance occurred in 37% of patients with MVR.
Conclusion

Viral response to interferon increases with treatment duration and favorably affects the natural course of disease. Interferon treatment duration has to be individualized with careful post-treatment assessment.

StephenW

慢性乙型肝炎患者干扰素治疗持续时间及其对自然病程的影响

Cihan Yurdaydin Onur KeskinÇağdaşKalkan Fatih Karakaya AysunÇalişkanGökhanKabaçamFOğuzÖnderSenem Karatayli Ersin Karatayli Xheni Deda ...显示更多
“传染病杂志”，jix656，https://doi.org/10.1093/infdis/jix656
发布时间：
2018年2月7日

抽象
背景

干扰素是慢性三角洲肝炎（CDH）唯一的治疗选择。 CDH数据库（333名患者，161名患有干扰素治疗史）分析治疗持续时间对病毒学应答和临床结果的影响。
方法

选择接受至少6个月干扰素的99名CDH患者。维持病毒学应答（MVR）被定义为停止治疗2年后的D型肝炎病毒RNA阴性。累积中位干扰素治疗时间为24个月（范围6-126个月），中位数为2个疗程（范围1-8）。治疗后中位随访时间为55个月（24-225个月）。
结果

35名患者达到MVR。 MVR累积概率随治疗时间延长而增加，5年达到50％。与没有MVR的患者相比，MVR患者死于肝脏疾病或发生并发症的可能性较小（P = 0.032，P = 0.006）。基线时的肝硬化和对治疗无反应（比值比分别为16.1和5.23）预测不利终点。 37％的MVR患者发生乙型肝炎表面抗原清除。
结论

对干扰素的病毒应答随治疗持续时间增加而有利地影响疾病的自然病程。干扰素治疗时间必须通过仔细的治疗后评估来个体化。