학술논문
Independent variables that determine virologic response at the end of pegylated interferon treatment in patients with chronic hepatitis B virus/Pegile interferon tedavisi alan kronik hepatit B infeksiyonlu olgularda tedavi sonu virolojik yaniti belirleyen bagimsiz degiskenler
ORIGINAL ARTICLE-KLINIK CALISMA
ORIGINAL ARTICLE-KLINIK CALISMA
Document Type
Academic Journal
Author
Source
Istanbul Medical Journal. March 2012, Vol. 13 Issue 1, p19, 10 p.
Subject
Language
Turkish
ISSN
1304-8503
Abstract
GIRIS Kronik hepatit B virus (HBV) infeksiyonu bugun dunyada 400 milyon kisiyi ilgilendiren onemli bir halk sagligi problemidir. Dunya Saglik Orgutu'ne gore dunya nufusunun yaklasik ucte biri serolojik olarak HBV [...]
Objectives: In this retrospective study, we evaluated variables that determine virological response at the end of pegylated interferon treatment in patients with chronic hepatitis B virus (HBV). Methods: Serum HBV DNA levels, serum alanine aminotransferase levels, HBeAg status, age, gender, body mass index, alcohol usage, liver biopsy findings, previous conventional interferon usage, and the type of pegylated interferon used were recordedfrom the medicalfiles of chronic hepatitis B patients. We investigated whether or not these parameters would affect end of treatment virological response to pegylated interferon. Results: Seventy-nine (54 HBeAg (-), 25 HBeAg (+)) patients were included in this study. One (4%) HBeAg (+) patient and 38 (70.4%) HBeAg (-) patients had virological response at the end of treatment. HBeAg seroconversion was observed in 10 of 16 (62.5%) HBeAg (+) patients. In HBeAg (-) patients, the baseline serum HBV DNA levels were lower and virologic response rates at the 3rd month of treatment were higher in cases who had virologic response at the end of treatment than in non-responders (serum HBV DNA levels 174000 IU/ ml and 4185000 IU/ml, p = 0.002; virologic response rate at the 3rd month of treatment 76.3% and 6.3%, p = 0.005, respectively). The baseline serum HBV DNA levels were higher in HBeAg (+) patients than in HBeAg (-) patients. Conclusion: In this study, we determined that baseline serum HBV DNA levels and early virological response (at 12 weeks of treatment) were the most important predictors for the end of treatment virological response in patients with chronic hepatitis B treated with pegylated interferon. We considered that the high rates of treatment failure among HBeAg (+) patients may be due to the baseline excessive serum HBV DNA levels in these patients. Key words: Pegylated interferon, virological response, hepatitis B virus. Amac: Bu geriye donuk calismada, kronik hepatit B virus (HBV) infeksiyonlu olgularda pegile interferon tedavisine tedavi sonu yaniti belirleyen degiskenleri inceledik. Gerec ve Yontem: Kronik HBV infeksiyonlu hasta dosyalarindan serum HBV DNA seviyeleri, serum ALT duzeyleri, HBeAg durumu, yas, cinsiyet, vucut kitle indeksi, alkol kullanimi, karaciger biyopsi bulgulari, onceki standart interferon kullanimi varligi ve kullanilan pegile interferonun tipi ile bilgiler bulundu. Bu degiskenlerin pegile interferon tedavisine virolojik yaniti etkileyip etkilemedigi incelendi. Bulgular: Bu calismaya 79 (54 HBeAg (-), 25 HBeAg (+)) olgu alindi. Bir (%4) HBeAg (+) hasta ve 38 (%70,4) HBeAg (-) hastada tedavi sonu virolojik yanit vardi. Onalti HBeAg (+) olgunun 10'unda (%62,5) HBeAg serokonversiyonu goruldu. HBeAg (-) olgularda tedavi sonu yanitli olanlarda yanitsiz olanlara gore tedavi oncesi serum HBV DNA duzeyi daha dusuk ve tedavinin ucuncu ayindaki virolojik yanit orani daha fazlaydi (Serum HBV DNA duzeyleri sirasiyla 174000 IU/ ml ve 4185000 IU/ml, p = 0,002; tedavinin ucucu ayi sonundaki virolojik yanit oranlari sirasiyla %76,3 ve %6,3, p = 0,005). HBeAg (+) olanlarda tedavi oncesi serum HBV DNA duzeyleri daha fazlaydi. Sonuc: Bu calismada pegile interferonla tedavi edilen kronik HBV infeksiyonlu olgularda tedavi oncesi HBV DNA duzeyinin ve erken virolojik yanitin (tedavinin 3. ayi sonu) tedavi sonu virolojik yanitin en onemli belirleyicileri oldugunu bulduk. HBeAg (+) olgulardaki tedavi basarisizliginin bu olgulardaki tedavi oncesi HBV DNA duzeylerinin yuksekligine bagli oldugunu dusunduk. Anahtar sozcukler: Pegile interferon; virolojik yanit; hepatit B virus.
Objectives: In this retrospective study, we evaluated variables that determine virological response at the end of pegylated interferon treatment in patients with chronic hepatitis B virus (HBV). Methods: Serum HBV DNA levels, serum alanine aminotransferase levels, HBeAg status, age, gender, body mass index, alcohol usage, liver biopsy findings, previous conventional interferon usage, and the type of pegylated interferon used were recordedfrom the medicalfiles of chronic hepatitis B patients. We investigated whether or not these parameters would affect end of treatment virological response to pegylated interferon. Results: Seventy-nine (54 HBeAg (-), 25 HBeAg (+)) patients were included in this study. One (4%) HBeAg (+) patient and 38 (70.4%) HBeAg (-) patients had virological response at the end of treatment. HBeAg seroconversion was observed in 10 of 16 (62.5%) HBeAg (+) patients. In HBeAg (-) patients, the baseline serum HBV DNA levels were lower and virologic response rates at the 3rd month of treatment were higher in cases who had virologic response at the end of treatment than in non-responders (serum HBV DNA levels 174000 IU/ ml and 4185000 IU/ml, p = 0.002; virologic response rate at the 3rd month of treatment 76.3% and 6.3%, p = 0.005, respectively). The baseline serum HBV DNA levels were higher in HBeAg (+) patients than in HBeAg (-) patients. Conclusion: In this study, we determined that baseline serum HBV DNA levels and early virological response (at 12 weeks of treatment) were the most important predictors for the end of treatment virological response in patients with chronic hepatitis B treated with pegylated interferon. We considered that the high rates of treatment failure among HBeAg (+) patients may be due to the baseline excessive serum HBV DNA levels in these patients. Key words: Pegylated interferon, virological response, hepatitis B virus. Amac: Bu geriye donuk calismada, kronik hepatit B virus (HBV) infeksiyonlu olgularda pegile interferon tedavisine tedavi sonu yaniti belirleyen degiskenleri inceledik. Gerec ve Yontem: Kronik HBV infeksiyonlu hasta dosyalarindan serum HBV DNA seviyeleri, serum ALT duzeyleri, HBeAg durumu, yas, cinsiyet, vucut kitle indeksi, alkol kullanimi, karaciger biyopsi bulgulari, onceki standart interferon kullanimi varligi ve kullanilan pegile interferonun tipi ile bilgiler bulundu. Bu degiskenlerin pegile interferon tedavisine virolojik yaniti etkileyip etkilemedigi incelendi. Bulgular: Bu calismaya 79 (54 HBeAg (-), 25 HBeAg (+)) olgu alindi. Bir (%4) HBeAg (+) hasta ve 38 (%70,4) HBeAg (-) hastada tedavi sonu virolojik yanit vardi. Onalti HBeAg (+) olgunun 10'unda (%62,5) HBeAg serokonversiyonu goruldu. HBeAg (-) olgularda tedavi sonu yanitli olanlarda yanitsiz olanlara gore tedavi oncesi serum HBV DNA duzeyi daha dusuk ve tedavinin ucuncu ayindaki virolojik yanit orani daha fazlaydi (Serum HBV DNA duzeyleri sirasiyla 174000 IU/ ml ve 4185000 IU/ml, p = 0,002; tedavinin ucucu ayi sonundaki virolojik yanit oranlari sirasiyla %76,3 ve %6,3, p = 0,005). HBeAg (+) olanlarda tedavi oncesi serum HBV DNA duzeyleri daha fazlaydi. Sonuc: Bu calismada pegile interferonla tedavi edilen kronik HBV infeksiyonlu olgularda tedavi oncesi HBV DNA duzeyinin ve erken virolojik yanitin (tedavinin 3. ayi sonu) tedavi sonu virolojik yanitin en onemli belirleyicileri oldugunu bulduk. HBeAg (+) olgulardaki tedavi basarisizliginin bu olgulardaki tedavi oncesi HBV DNA duzeylerinin yuksekligine bagli oldugunu dusunduk. Anahtar sozcukler: Pegile interferon; virolojik yanit; hepatit B virus.