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学科主题: 临床医学
题名:
Effect of spleen operation on antiviral treatment in hepatitis C virus-related cirrhotic patients
作者: Feng, Bo; Zhang, Wei; Luo, Bi-Fen; Song, Guang-Jun; Wang, Jian; Jin, Qian; Qin, Hong; Wei, Lai
关键词: Hepatitis C virus cirrhosis ; Interferon ; Ribavirin ; Splenectomy ; Partial splenic embolization
刊名: WORLD JOURNAL OF GASTROENTEROLOGY
发表日期: 2014-11-07
DOI: 10.3748/wjg.v20.i41.15387
卷: 20, 期:41, 页:15387-15397
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Gastroenterology & Hepatology
研究领域[WOS]: Gastroenterology & Hepatology
关键词[WOS]: PARTIAL SPLENIC EMBOLIZATION ; LAPAROSCOPIC SPLENECTOMY ; COMBINATION THERAPY ; PEGYLATED INTERFERON ; THROMBOCYTOPENIA ; INFECTION ; RIBAVIRIN ; GENOTYPE ; HYPERSPLENISM ; PEGINTERFERON
英文摘要:

AIM: To investigate the impact of spleen operation (SO) on interferon-alpha (IFN-alpha)-based antiviral treatment in patients with hepatitis C virus (HCV)-related cirrhosis.

METHODS: Studies were systematically identified by searching electronic databases including MEDLINE, Cochrane Library, Elsevier, and Embase up to September 30, 2013, and relevant clinical studies were reviewed. Sustained virological response (SVR) rate and adherence to therapy were taken as the endpoints of interest.

RESULTS: A total of 603 patients from 16 studies were included in the systematic review. Of 372 patients who underwent SO followed by antiviral treatment, the total SVR rate was 39.5%. SVR was associated with HCV genotypes 2/3 (OR = 10.84; 95%CI: 5.47-21.47; P < 0.00001). IFN-alpha dose needed to be reduced in 29.4%, and IFN-alpha-based therapy was discontinued in 11.5% of patients. Analysis of controlled studies showed that SVRs were achieved in 34.1% of patients with SO and 31.1% of patients without SO. SO had no effect on the SVR rate in cirrhotic patients with genotype 1 HCV infection (OR = 1.28; 95%CI: 0.51-3.22; P = 0.60), but improved the SVR rate in patients with genotypes 2/3 infection, though the difference was not significant (OR = 0.36; 95%CI: 0.13-1.02; P = 0.05).

CONCLUSION: SO combined with IFN-alpha-based antiviral therapy may be suitable in cirrhotic patients with genotypes 2/3 HCV infection, but not in those with genotype 1 infection. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.

语种: 英语
所属项目编号: 2012ZX10002-003 ; 2012ZX09303-019 ; 7122191
项目资助者: National S and T Major Project for Infectious Diseases Control ; National Major S and T Special Project for "Significant New Drugs Development" ; Beijing Natural Science Foundation
WOS记录号: WOS:000345115100041
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/64552
Appears in Collections:北京大学第二临床医学院_北京大学肝病研究所_期刊论文

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作者单位: Peking Univ, Peoples Hosp, Inst Hepatol, Beijing Key Lab Hepatitis C & Immunotherapy Liver, Beijing 100044, Peoples R China

Recommended Citation:
Feng, Bo,Zhang, Wei,Luo, Bi-Fen,et al. Effect of spleen operation on antiviral treatment in hepatitis C virus-related cirrhotic patients[J]. WORLD JOURNAL OF GASTROENTEROLOGY,2014,20(41):15387-15397.
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