[根据非干扰素治疗方案(环孢素+利巴韦林)治疗的肝硬化和慢性丙型肝炎病毒终末期患者血清和外周单核细胞中病毒载量 HCV-RNA 的动力学]。

Q4 Medicine Antibiotiki i Khimioterapiya Pub Date : 2015-01-01
V V Stelmah, V K Kozlov, A N Nekrasova
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引用次数: 0

摘要

本文描述了一例肝硬化合并慢性丙型肝炎终止期(1b 基因型)的临床病例。考虑到患者处于肝硬化阶段、外周单核细胞中存在肝外 HCV 复制、不利的 HCV 基因型、不利的 IL-28B 基因多态性、前两个疗程的标准抗病毒疗法(PegIFN + 利巴韦林)效果不佳以及继发性免疫缺陷,该患者接受了为期 24 周的非干扰素抗病毒疗法:环形干扰素联合利巴韦林的干扰素诱导疗法。在治疗的第 12 周,患者出现了生化缓解,血清中的病毒载量从 1 x 10(7) IU/ml 降至 7 x 10(5) IU/ml,外周单核细胞中的病毒载量从 1.35 x 10(7) IU/ml 降至 8 x 10(5) IU/m。外周单核细胞中病毒血症分子生物学标志物(PCR HCV-RNA)的检测是疑似肝外 HCV 感染病例的必备诊断技术。慢性丙型病毒性肝炎肝硬化阶段患者的病毒载量动力学和免疫学指标的积极动态表明,当重组干扰素被禁用时,使用非干扰素治疗方案(环干扰素+利巴韦林)是有效的病因治疗方法。
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[Kinetics of Virus Load HCV-RNA in Blood Serum and Peripheral Mononuclear Cells in a Patient with Hepatocirrhosis and Chronic Virus Hepatitis C Termination Treated According to Noninterferon Treatment Scheme (Cycloferon + Ribavirin)].

A clinical case of hepatocirrhosis with chronic hepatitis C termination (1b genotype) is described. Taking into account the cirrhotic stage of the disease, the extrahepatic HCV replication in the peripheral mononuclears, unfavourable HCV genotype, infavourable IL-28B gene polymorphism, inefficiency of the previous two courses of the standard antiviral therapy (PegIFN + ribavirin) and secondary immune deficiency, noninterferon antiviral therapy for 24 weeks was used in the treatment of the patient: interferon-inductive therapy with cycloferon in combination with ribavirin. There was observed by the 12th week of the treatment biochemical remission and a significant decrease of the virus load from 1 x 10(7) IU/ml to 7 x 10(5) IU/ml in the blood serum and from 1.35 x 10(7) IU/ml to 8 x 10(5) IU/m in the peripheral mononuclears. Investigation of the molecular biological markers of the viremia (PCR HCV-RNA) in the cells of peripheral mononuclears is an obligatory diagnostic technology in cases with suspected extrahepatic HCV infection. The kinetics of the virus load and the positive dynamics of the immunological indices in the patient at the cirrhotic stage of chronic virus hepatitis C are indicative of the efficient etiopathogenic approach with the use of the noninterferon treatment scheme (cycloferon + ribavirin), when recombinant interferons are contraindicated.

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来源期刊
Antibiotiki i Khimioterapiya
Antibiotiki i Khimioterapiya Medicine-Infectious Diseases
CiteScore
0.80
自引率
0.00%
发文量
46
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