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Analysis of Blood Biochemical Factors Associated with Rapid Virological Response and Early Virological Response to Antiviral Treatment in Chronic Hepatitis C

Author: YanFei
Tutor: FengJiHong
School: Dalian Medical University
Course: Internal Medicine
Keywords: chronic hepatitis C influential factors treatment rapid virological response early virological response
CLC: R512.63
Type: Master's thesis
Year: 2013
Downloads: 15
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Abstract


Objective: Hepatitis C is a contagious liver disease that results from infectionwith the hepatitis C virus(HCV). It can range in severity from a mild illness lasting afew weeks to a serious, lifelong illness. Every year,3~4million people are infectedwith the HCV. About150million people are chronically infected and at risk ofdeveloping liver cirrhosis and/or liver cancer. More than350000people die fromhepatitis C-related liver diseases every year. Hepatitis C is found worldwide. China isone of Countries with high rates of chronic infection.Previous studies have shown thatchronic hepatitis C patients who treated with peginterferon α-2a plus ribavirin wouldhave a great chance to achieve sustained virological response(SVR) if he got rapidvirological response(RVR) or early virological response(EVR). This study was aimedat to determine the blood biochemical factors such as blood cell andliver functionassociated with RVR and EVR in chronic hepatitis C patients treated withpeginterferon and ribavirin,predict the disease outcome and give individualizedtherapy.Methods: To select inpatient with total94cases in The sixth people’s hospital ofDalian during the period from January,2009to June,2012.All of them infectedchronically with hepatitis C virus and treated with peginterferon α-2a plus ribavirin.All patients received180μg/w of peginterferon α-2a. The ribavirin doses were800~1200mg/d based on body weight. HCV RNA, blood cell and liver function levelswere examined before treatment and after4,12weeks of treatment. The patients weredivided into RVR group (RVR) and no RVR group(non-RVR) according to whether hecould undetectable hepatitis C virus (HCV) ribonucleic acid (RNA) at4week afterantiviral treatment and divided into complete EVR(cEVR) group (cEVR) and no cEVR group(non-cEVR) according to whether he could undetectable HCV RNA at12weekafter antiviral treatment. A retrospective analysis were performed to explore thepossible influence factors of blood cell,liver function and others associated with RVRand cEVR.Results: A total of94patients were included in the study. Mean age of thepatients was46.93±13.38years,63.83%were male.54cases(57.45%) achieved RVRand79cases (84.04%) achieved cEVR.RVR vs. non-RVR:In the univariate analysis,baseline viral load(HCV RNA<1×106IU/ml) was associated with RVR(χ2=6.017,P=0.014). By the method of logistic multiple regression, baseline viral load (OR:3.317;95%CI:1.291to8.521; P=0.013) and red blood cell (RBC) count before treatment(OR:2.492;95%CI:1.099to5.650; P=0.029) were all independent predictors ofRVR.cEVR vs. non-cEVR:In the univariate analysis, alanine aminotransferase level(ALT) was associated with RVR(P=0.007). By the method of logistic multipleregression, baseline viral load (OR:5.040;95%CI:1.130to22.481; P=0.034) andPlatelet(PLT) count before treatment (OR:1.018;95%CI:1.002to1.034; P=0.028)were all independent predictors of cEVR. In repeated measurement analysis, Changesof blood cell and liver function during the treatment have no effect on whether the viralresponse achieved. Hypertension, diabetes mellitus and fatty liver disease were notassociated with RVR or cEVR. The aspartate aminotransferase (AST) to PLT ratioindex (APRI) is one of several markers that have been proposed to measure liverfibrosis,it was not associated with RVR or cEVR.Conclusion:1. Baseline viral load before treatment is a independent predictor of RVR andcEVR. Low viral load is easy to achieve RVR or cEVR.2. RBC count before treatment is a independent predictor of RVR. High RBC iseasy to achieve RVR.3. PLT count before treatment is a independent predictor of cEVR. High PLT iseasy to achieve cEVR.4.Changes of blood cell and liver function during the treatment have no effect onwhether the viral response.

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CLC: > Medicine, health > Internal Medicine > Infectious disease > Viral infections > Viral Hepatitis > Hepatitis C (non- A non-B )
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