摘要
目的探讨HBV/HCV合并感染患者的临床特征以及对聚乙二醇干扰素α-2a(PEGIFNα-2a)联合利巴韦林的抗病毒疗效。方法选取收治的HBV/HCV合并感染患者45例(A组),单纯HBV感染患者49例(B组),单纯HCV感染患者38例(C组),比较病毒感染和抗病毒疗效。结果 A组与B组HBe Ag阳性率、HBV DNA阳性率、HBV DNA平均值以及HBV DNA量的患者分布差异有统计学意义(P<0.05);A组与C组HCV RNA平均值差异无统计学意义(P>0.05),HCV RNA量的患者分布差异有统计学意义(P<0.05);A组与C组基因型分布、HCV RNA和ALT差异无统计学意义(P>0.05),PLT、WBC、PTA和Alb差异具有统计学意义(P<0.05);Ⅰ基因型中,A组与C组p EVR、ETVR以及复发率差异有统计学意义(P<0.05),RVR、c EVR以及SVR差异无统计学意义(P>0.05);非Ⅰ基因型中,RVR、c EVR、p EVR、ETVR、SVR以及复发率差异均无统计学意义(P>0.05);A组与C组不良反应例数以及WBC和PLT减少例数差异有统计学意义(P<0.05),溶血以及甲状腺功能减退差异无统计学意义(P>0.05);未获得SVR患者和获得SVR患者阳转率差异具有统计学意义(P<0.05)。结论丙型和乙型肝炎合并感染患者以HCV为优势病毒株为主,HBV复制受抑制。合并感染Ⅰ基因型患者复发率、部分早期病毒学应答和治疗结束时病毒学应答高于单纯HCV感染患者,持续病毒学应答相似,但合并感染对非基因Ⅰ型病毒学应答率无影响。
Objective To investigate the clinical characteristics in patients with concurrent infection of hepatitis C and hepatitis B,and to observe the antiviral curative effects of pegylated interferon （PEGIFNα-2a） combined with ribavirin on the disease.Methods A total of 132 patients who were treated in our hospital from January 2013 to December 2015 were enrolled in the study.These patients were divided into three groups, in which 45 patients with concurrent infection of hepatitis C and hepatitis B in group A,49 patients with simple HBV infection in group B,and 38 patients with simple HCV infection in group C.The infectious status of pateints and the antiviral curative effects were observed and compared among the three groups.Results There were significant differences in HBeAg positive rate, HBV DNA positive rate, average value of HBV DNA and the distribution of patients with HBV DNA between group A and group B （ P 〈0.05）.There was no significant difference in average value of HCV RNA between group A and group C （ P 〉0.05 ） , however, there was a significant difference in the distribution of patients with HBV DNA bewteen group A and group C （ P 〈0.05） .There were no significant differences in the distribution of genotype,HCV RNA,ALT between group A and group C （ P 〉0.05）,however, there were significant differences in PLT, WBC, PTA,Alb between the two groups （ P 〈0.05）.InⅠgenotype, there were significant differences in pEVR,ETVR and relapse rate between group A and group C （ P 〉0.05）,but there were no significant differences in RVR,cEVR and SVR between the two groups （ P 〉0.05）.Moreover in non-Ⅰgenotype, there were no significant differences in RVR, cEVR, pEVR, ETVR, SVR and relapse rate between the two groups （ P 〉0.05）.There were significant differences in the cases with adverse reactions or the decrease of WBC, PLT between group A and group C （P〈0.05）, however, there were no significant differences in the cases with haemolysis or hypothyrosis between the two groups （ P 〉0.05）.Besides there was a significant difference in positive conversion rate between the patients with SVR and patients without SVR （ P 〈0.05）.Conclusion HCV is dominant in patients with concurrent infection of HCV and HBV, and HBV replication is suppressed.The relapse rate, partial early virological response and the virological response at end of treatment in patients with concurrent infection ofⅠgenotype are higher than those in patients with simple HCV infection, moreover, sustained virological response is similar,however, concurrent infection has no effects on virological response in non-Ⅰgenotype.
出处
《河北医药》
CAS
2016年第22期3378-3381,共4页
Hebei Medical Journal
