乙型合并丙型肝炎病毒感染患者的临床特征及抗病毒治疗策略

Clinical characteristics and antiviral strategy of patients with hepatitis B and hepatitis C virus infection

目的分析乙型肝炎病毒(HBV)合并丙型肝炎病毒(HCV)感染患者的临床特征,并探讨其抗病毒治疗策略。方法50例HBV合并HCV感染患者设为研究组,并将同期收治的50例单纯HBV感染患者设为对照组。两组均给予利巴韦林联合人工重组干扰素治疗。比较两组患者的病毒学特征、病毒学应答效果、肝功能指标[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)]、不良反应发生率、复发情况。结果观察组患者中,HCV优势病毒株45例(90.00%),混合优势病毒株8例(16.00%)。观察组患者的乙型肝炎e抗原(HBeAg)阳性率24.00%低于对照组的44.00%,差异有统计学意义(P<0.05)。观察组患者的总应答率96.00%高于对照组的72.00%,差异有统计学意义(P<0.05)。治疗前,两组患者的ALT、AST比较,差异均无统计学意义(P>0.05);治疗后,两组患者的ALT、AST均较本组治疗前降低,且观察组降低幅度大于对照组,差异均具有统计学意义(P<0.05)。观察组患者的不良反应发生率36.00%高于对照组的12.00%,差异有统计学意义(P<0.05)。观察组患者的复发率46.00%高于对照组的14.00%,差异有统计学意义(P<0.05)。结论HBV合并HCV感染患者采用利巴韦林联合人工重组干扰素治疗可以取得明显的应答效果,且能有效改善患者的肝功能指标,但毒副作用大,易复发,值得临床深入分析。

Objective To analyze the clinical characteristics and antiviral strategy of patients with hepatitis B virus(HBV)and hepatitis C virus(HCV)infection.Methods There were 50 cases of HBV complicated with HCV as research group,and another concurrent 50 cases of HBV infection as the control group.Both groups were treated with ribavirin combined with artificial recombinant interferon.The virological characteristics,virological response effects,liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST)],incidence of adverse reactions,and recurrence were compared between the two groups.Results In the observation group,there were 45 cases(90.00%)with dominant HCV strains and 8 cases(16.00%)with mixed dominant HCV strains.The positive rate of hepatitis B e antigen(HBeAg)of the observation group was 24.00%,which was lower than 44.00%of the control group,and the difference was statistically significant(P<0.05).The total response rate 96.00%of the observation group was higher than 72.00%of the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in ALT and AST between the two groups(P>0.05).After treatment,the ALT and AST of the two groups were lower than those before treatment,and the observation group has a greater reduction than the control group.All the difference was statistically significant(P<0.05).The incidence of adverse reactions 36.00%of the observation group was higher than 12.00%of the control group,and the difference was statistically significant(P<0.05).The recurrence rate 46.00%of the observation group was higher than 14.00%of the control group,and the difference was statistically significant(P<0.05).Conclusion Combination of ribavirin and artificial recombinant interferon can achieve obvious effect on hepatitis B complicated with hepatitis C virus infection,and can effectively improve the liver function index of patients,but the side effects are large,easy to relapse.It is worthy of clinical in-depth analysis.