CAJ | 학술논문

目的探讨聚乙二醇化干扰素(PEG-IFNα)联合利巴韦林治疗肝移植术后丙型肝炎复发的效果及安全性.方法回顾性分析9例丙型肝炎相关终末期肝病患者接受肝移植的临床资料,其中5例受者术后出现丙型肝炎复发,均给予PEG-IFNα-2a联合利巴韦林抗HCV治疗,疗程为48周.观察治疗前后血红蛋白、白细胞计数、移植肝功能及HCV RNA复制水平等指标的变化,评估治疗后的早期病毒应答(EVR)、持续性病毒应答(SVR)及不良反应等.结果 5例受者中有3例在治疗12周内达到EVR,并在治疗后获得SVR,移植肝功能也恢复正常；1例因在治疗12周后HCVRNA的下降达不到2个对数级而停药,1例虽HCV RNA下降2个对数级以上,但治疗至24周时HCV RNA未转阴而停药,至48周时HCV RNA均维持在较低水平.5例丙型肝炎复发受者在治疗后均发生白细胞减少和(或)发热等不良反应,给予对症处理后好转.结论 PEG-IFNα联合利巴韦林治疗肝移植后丙型肝炎复发安全性好,多数受者可取得持续性病毒学应答.
목적 탐토취을이순화간우소(PEG-IFNα)연합리파위림치료간이식술후병형간염복발적효과급안전성.방법 회고성분석9례병형간염상관종말기간병환자접수간이식적림상자료,기중5례수자술후출현병형간염복발,균급여PEG-IFNα-2a연합리파위림항HCV치료,료정위48주.관찰치료전후혈홍단백、백세포계수、이식간공능급HCV RNA복제수평등지표적변화,평고치료후적조기병독응답(EVR)、지속성병독응답(SVR)급불량반응등.결과 5례수자중유3례재치료12주내체도EVR,병재치료후획득SVR,이식간공능야회복정상；1례인재치료12주후HCVRNA적하강체불도2개대수급이정약,1례수HCV RNA하강2개대수급이상,단치료지24주시HCV RNA미전음이정약,지48주시HCV RNA균유지재교저수평.5례병형간염복발수자재치료후균발생백세포감소화(혹)발열등불량반응,급여대증처리후호전.결론 PEG-IFNα연합리파위림치료간이식후병형간염복발안전성호,다수수자가취득지속성병독학응답.
Objective To investigate the effective regimen and security to treat the hepatitis C virus (HCV) recurrence after orthotopic liver transplantation (OLT).Methods The clinical data of 9 cases of HCV related end-stage hepatopathy after liver transplantation were retrospectively analyzed.Five patients with recurrent HCV after OLT were selected for treatment,and all of them were given pygylated interferon αα-2a and ribavirin.The treatment course was 48 weeks.The changes in hemoglobin,white blood cells,transaminase,and HCV RNA copies were observed before and after treatment.The early viral response (EVR),sustained viral response (SVR) and adverse reactions were assessed.Results Three cases out of 5 cases of HCV recurrence after OLT obtained EVR within 12 weeks,all of them obtained SVR after the treatment,and the function of the transplanted liver returned to normal; In one case,HCV RNA was declined by less than 102 copies after 12 weeks of treatment,and the treatment was terminated; In one case,HCV RNA was declined by greater than 102 copies after 12 weeks of treatment,and at 24th week,HCV RNA was still positive and the treatment was terminated,but HCV RNA remained at a low level at 48th week.Side effects occurred in all 5 cases after antiviral treatment,and alleviated after symptomatic treatment.Conclusion To treat the recurrence of HCV timely after OLT by pygylated interferon (in combination with ribavirin was safe,and the majority of patients could achieved sustained virological response.