论文部分内容阅读
AIM:To evaluate the association between liver stiffness(LS) prior to the initiation of dual/triple therapy and viral response.METHODS:LS was measured in all patients before treatment was administered.The therapeutic approach was based on hepatic,virological,and immunological evaluations and considered the fact that patients with severe fibrosis(F3)or compensated cirrhosis(F4)in Child-Pugh class A are the primary candidates for triple therapy.In total,65 hepatitis C virus(HCV)patients were treated with Peg-interferon/ribavirin(Peg-IFN/RBV);24patients were classified as genotypes 1/4(36.92%),and41 patients were classified as genotypes 2/3(63.08%)(dual therapy).In addition,20 HCV treatment-experienced genotype 1 patients were treated with Peg IFN-RBV and boceprevir(triple therapy).Wilcoxon rank-sum tests were used to compare the groups.RESULTS:LS significantly differed between dual therapy and triple therapy(P=0.002).The mean LS value before dual therapy treatment was 8.61±5.79k Pa and was significantly different between patients achieving a sustained virologic response(SVR)24weeks after therapy and those who did not(7.23±5.18 k Pa vs 11.72±5.99 k Pa,respectively,P=0.0003).The relative risk of non-response to therapy was 4.45(95%CI:2.32-8.55).The attributable risk of non-response to therapy was 49%.The mean LSvalue before triple therapy treatment was 13.29±8.57k Pa and was significantly different between patients achieving and not achieving SVR24(9.41±5.05 vs19.11±9.74,respectively;P=0.008).The relative risk of non-response to therapy was 5.57%(95%CI:1.50-20.65).The attributable risk of non-response to therapy(70%)was increased compared with dual therapy patients.Pre-treatment stiffness>12 k Pa was significantly associated with non-SVR(P<0.025)in both groups.CONCLUSION:Pre-treatment liver stiffness may be useful for predicting the response to treatment in patients treated with either dual or triple anti-HCV therapy.
AIM: To evaluate the association between liver stiffness (LS) prior to the initiation of dual / triple therapy and viral response. METHODS: LS was measured in all patients before treatment was administered. The therapeutic approach was based on hepatic, virological, and immunological evaluations and considered the fact that patients with severe fibrosis (F3) or compensated cirrhosis (F4) in Child-Pugh class A are the primary candidates for triple therapy.In total, 65 hepatitis C virus (HCV) patients were treated with Peg-interferon / ribavirin (Peg-IFN / RBV); 24patients were classified as genotypes 1/4 (36.92%), and41patients were classified as genotypes 2/3 (63.08%) 1 patients were treated with Peg IFN-RBV and boceprevir (triple therapy). Wilcoxon rank-sum tests were used to compare the groups .RESULTS: LS significant differed between dual therapy and triple therapy (P = 0.002). Mean LS value before dual therapy treatment was 8.61 ± 5.79k Pa and w as significantly different patients achieving a sustained virologic response (SVR) 24 weeks after therapy and those who did not (7.23 ± 5.18 k vs 11.72 ± 5.99 k Pa, respectively, P = 0.0003). The relative risk of non-response to therapy was 4.45 (95% CI: 2.32-8.55). The attributable risk of non-response to therapy was 49%. The mean LSvalue before triple therapy treatment was 13.29 ± 8.57k Pa and was significantly different patients achieving and not achieving SVR24 ( 9.41 ± 5.05 vs 19.11 ± 9.74, respectively; P = 0.008). The relative risk of non-response to therapy was 5.57% (95% CI: 1.50-20.65) ) was increased compared with dual therapy patients. Pre-treatment stiffness> 12 kPa was associated with non-SVR (P <0.025) in both groups. CONCLUSION: Pre-treatment liver stiffness may be useful for predicting the response to treatment in patients treated with either dual or triple anti-HCV therapy.