新发传染病电子杂志2024，Vol.9Issue(6)：54-59,6.DOI:10.19871/j.cnki.xfcrbzz.2024.06.010
慢性丙型肝炎基因1型患者抗病毒治疗对丙型肝炎病毒核心抗原、肝脂肪变性和纤维化的影响
Effects of antiviral therapy on HCV core antigen,hepatic steatosis,and fibrosis in patients with chronic hepatitis C genotype 1
摘要
Abstract
Objective To determine the changes in hepatitis C virus core antigen(HCV Ag),controlled attenuation parameter(CAP),and fibrosis index based on 4 factors(FIB-4)during direct antiviral agent(DAA)treatment in patients with chronic hepatitis C(CHC)genotype 1,and their relationship with treatment outcomes.Method Fifty-one CHC patients who were treated with DAA in Our hospital from March 2020 to May 2021 were selected as the study objects.Sustained virological response(SVR)12 was defined as a sustained virological response of less than 12U/ml at the end of 12 weeks of treatment HCV Ag and HCV RNA levels were assessed at baseline,4 weeks of treatment,8 weeks of treatment,at the end of treatment,and 12 weeks after the end of treatment.HCV Ag was determined by chemiluminescent microparticle immunoassay.CAP and FIB-4 were assessed at baseline,at the end of treatment,and 12 weeks after treatment.Result A total of 49 patients(96.08％)were positive for both HCV Ag(＞3fmol/L)and HCV RNA at baseline,and the remaining 2 patients were positive only for HCV RNA(124U/ml and 876U/ml,respectively).There was a significant positive correlation between HCV Ag and HCV RNA at baseline(P＜0.001).During DAA treatment,56.86％of patients had no detectable HCV Ag at week 4,84.31％at week 8,and 100％at the end of treatment.Twelve weeks after the end of treatment,49 patients(96.08％)achieved SVR 12,and HCV Ag and HCV RNA tests were highly consistent.Both HCV Ag and HCV RNA at 4 and 8 weeks of treatment had higher positive predictive values in predicting SVR12.CAP values were significantly increased at 12 weeks after treatment compared with baseline(P＜0.05).FIB-4 values at the end of treatment and 12 weeks after treatment were significantly decreased(P＜0.05),and FIB-4 was further decreased at 12 weeks after treatment than at the end of treatment(P＜0.05).Finally,there was a positive correlation between the change in FIB-4 from baseline and baseline HCV Ag at 12 weeks after treatment(P＜0.05).Conclusion During DAA treatment,the use of HCV Ag can monitor the treatment outcomes of genotype 1 HCV patients,and DAA improves liver fibrosis in patients.On the other hand,there is an increasing trend of liver steatosis.关键词
慢性丙型肝炎/直接抗病毒药物/丙型肝炎病毒核心抗原/受控衰减参数/基于4项因素的肝纤维化指数Key words
Chronic hepatitis C/Direct antiviral agent/Hepatitis C virus core antigen/Controlled attenuation parameter/Fibrosis index based on the 4 factors分类
医药卫生引用本文复制引用
高兴娟,程磊,马秀清,刘守珠,王宝英,刘海燕,才德吉,杨兴唐..慢性丙型肝炎基因1型患者抗病毒治疗对丙型肝炎病毒核心抗原、肝脂肪变性和纤维化的影响[J].新发传染病电子杂志,2024,9(6):54-59,6.基金项目
青海省科技厅指导性计划项目(2022-ZJ-766) （2022-ZJ-766）
