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Boceprevir plus peginterferon/ribavirin for treatment ofchronic hepatitis C in Russia
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作者 Vasily Isakov Igor Nikitin +6 位作者 Vladimir Chulanov Pavel Ogurtsov Ekaterina Lukyanova Jianmin Long JaniceWahl Frans A Helmond the P08160 Trial Investigators 《World Journal of Hepatology》 CAS 2016年第6期331-339,共9页
AIM: to evaluate addition of boceprevir to peginterferon/ribavirin(PR) in Russian patients with chronic hepatitis C virus(HCV).METHODS: treatment-naive(t N) and treatmentexperienced(t E) patients(who had failed prior ... AIM: to evaluate addition of boceprevir to peginterferon/ribavirin(PR) in Russian patients with chronic hepatitis C virus(HCV).METHODS: treatment-naive(t N) and treatmentexperienced(t E) patients(who had failed prior treatment with PR for ≥ 12 wk) with chronic HCV genotype 1 infection were enrolled in this placebocontrolled, double-blind study. All patients initially received PR for 4 wk. Patients randomized to control treatment then received PR for an additional 44 wk. t N patients randomized to triple therapy received boceprevir(800 mg three times daily) plus PR for 24 wk and then further therapy according to treatment week 8(t W8) HCV RNA levels. t E patients received boceprevir plus PR for 32 wk and then further therapy according to t W8 HCV RNA levels. treatment was discontinued for t N patients with detectable HCV RNA at t W24 and t E patients with detectable HCV RNA at t W12 because of futility. the primary efficacy end point was sustained virologic response(SVR) defined as undetectable HCV RNA 24 wk after completing all study therapy.RESULTS: SVR was 74.8% in the boceprevir plus PR arm compared with 46.2% in the control arm, with a stratification-adjusted treatment difference of 29.2%(95%CI: 16.4-41.5; P < 0.0001). Rates of SVR were higher in the boceprevir arm in both t N and t E patient groups(t N 78.4% vs 56.3%; t E 69.4% vs 30.0%). Within t E patients, the rates of SVR were higher with boceprevir plus PR compared with PR, regardless of treatment failure type(null responder, partial responder, and relapser). Most patients receiving boceprevir plus PR in both t N(86%) and t E(71%) populations were eligible for reduced treatment duration. Anemia was increased in patients receiving boceprevir plus PR vs PR alone(47.2% vs 24.4%); there was a corresponding increase in ribavirin dose reduction and erythropoietin use. Among patients receiving boceprevir plus PR, SVR rates were similar in patients with anemia(< 10 g/d L) and those without anemia(71.2% vs 77.4%).CONCLUSION: Regulatory approval has been obtained for boceprevir plus PR in Russian patients with HCV genotype 1 infection based on the results of this study. 展开更多
关键词 HEPATITIS C virus BOCEPREVIR peginterferon ribavirin RANDOMIZED clinical trial SUSTAINED virologicresponse
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Recurrence and influencing factors of hepatitis B surface antigen seroclearance induced by peginterferon alpha-based regimens
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作者 Rui Lu Meng Zhang +13 位作者 Zi-Han Liu Miao Hao Yan Tian Mei Li Feng-Ping Wu Wen-Jun Wang Juan-Juan Shi Xin Zhang Xiao-Li Jia Zi-Cheng Jiang Xue-Mei Li Guang-Hua Xu Ya-Ping Li Shuang-Suo Dang 《World Journal of Gastroenterology》 SCIE CAS 2024年第44期4725-4737,共13页
BACKGROUND The long-term stability of hepatitis B surface antigen(HBsAg)seroclearance following peginterferon alpha(peg-IFN-α)-based therapy has not been extensively studied,leaving the full potential and limitations... BACKGROUND The long-term stability of hepatitis B surface antigen(HBsAg)seroclearance following peginterferon alpha(peg-IFN-α)-based therapy has not been extensively studied,leaving the full potential and limitations of this strategy unclear.AIM To assess HBsAg recurrence after seroclearance achieved by peg-IFN-αregimens.METHODS This prospective,multicenter,observational study was conducted from November 2015 to June 2021 at three Chinese hospitals:The Second Affiliated Hospital of Xi’an Jiaotong University,Ankang Central Hospital,and The Affiliated Hospital of Yan’an University.Participants who achieved HBsAg seroclearance following peg-IFN-α-based treatments were monitored every 4-12 weeks post-treatment for hepatitis B virus(HBV)markers,HBV DNA,and liver function.The primary outcome was HBV recurrence,defined as the reemergence of HBsAg,HBV DNA,or both,at least twice within 4-8 weeks of follow-up.RESULTS In total,121 patients who achieved HBsAg seroclearance were enrolled.After a median follow-up of 84.0(48.0,132.0)weeks,four subjects were lost to follow-up.HBsAg recurrence was detected in 16 patients.The cumulative HBsAg recurrence rate in the intention-to-treat population was 15.2%.Multivariate logistic regression analysis demonstrated that consolidation time<12 weeks[odds ratio(OR)=28.044,95%CI:4.525-173.791]and hepatitis B surface antibody disappearance during follow-up(OR=46.445,95%CI:2.571-838.957)were strong predictors of HBsAg recurrence.HBV DNA positivity and decompensation of liver cirrhosis and hepatocellular carcinoma were not observed.CONCLUSION HBsAg seroclearance following peg-IFN-αtreatment was durable over 84 weeks of follow-up with a cumulative recurrence rate of 15.2%. 展开更多
关键词 Chronic hepatitis B peginterferon alpha Hepatitis B surface antigen seroclearance Hepatitis B surface antigen recurrence Clinical cure
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Factors associated with early virological response to peginterferon-α-2a/ribavirin in chronic hepatitis C 被引量:2
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作者 Javier García-Samaniego Miriam Romero +6 位作者 Rafael Granados Remedios Alemán Miguel Jorge Juan Dolores Suárez Ramón Pérez Gregorio Castellano Carlos González-Portela 《World Journal of Gastroenterology》 SCIE CAS 2013年第12期1943-1952,共10页
AIM: To evaluate the impact of sociodemographic/clinical factors on early virological response (EVR) to pegin-terferon/ribavirin for chronic hepatitis C (CHC) in clinical practice. METHODS: We conducted a multicenter,... AIM: To evaluate the impact of sociodemographic/clinical factors on early virological response (EVR) to pegin-terferon/ribavirin for chronic hepatitis C (CHC) in clinical practice. METHODS: We conducted a multicenter, cross-sectional, observational study in Hepatology Units of 91 Spanish hospitals. CHC patients treated with peginterferon α-2a plus ribavirin were included. EVR was defined as undetectable hepatitis C virus (HCV)-ribonucleic acid (RNA) or ≥ 2 log HCV-RNA decrease after 12 wk of treatment. A bivariate analysis of sociodemographic and clinical variables associated with EVR was carried out. Independent factors associated with an EVR were analyzed using a multiple regression analysis that included the following baseline demographic and clinical variables: age (≤ 40 years vs > 40 years), gender, race, educational level, marital status and family status, weight, alcohol and tobacco consumption, source of HCV infection, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, and gamma glutamyl transpeptidase (GGT) (≤ 85 IU/mL vs > 85 IU/mL), serum ferritin, serum HCV-RNA concentration (< 400 000 vs ≥ 400 000), genotype (1/4 vs 3/4), cirrhotic status and ribavirin dose (800/1000/1200 mg/d).RESULTS: A total of 1014 patients were included in the study. Mean age of the patients was 44.3 ± 9.8 years, 70% were male, and 97% were Caucasian. The main sources of HCV infection were intravenous drug abuse (25%) and blood transfusion (23%). Seventyeight percent were infected with HCV genotype 1/4 (68% had genotype 1) and 22% with genotypes 2/3. The HCV-RNA level was > 400 000 IU/mL in 74% of patients. The mean ALT and AST levels were 88.4 ± 69.7 IU/mL and 73.9 ± 64.4 IU/mL, respectively, and mean GGT level was 82 ± 91.6 IU/mL. The mean ferritin level was 266 ± 284.8 μg/L. Only 6.2% of patients presented with cirrhosis. All patients received 180 mg of peginterferon α-2a. The most frequently used ribavirin doses were 1000 mg/d (41%) and 1200 mg/d (41%). The planned treatment duration was 48 wk for 92% of patients with genotype 2/3 and 24 wk for 97% of those with genotype 1/4 (P < 0.001). Seven percent of patients experienced at least one reduction in ribavirin or peginterferon α-2a dose, respectively. Only 2% of patients required a dose reduction of both drugs. Treatment was continued until week 12 in 99% of patients. Treatment compliance was ≥ 80% in 98% of patients. EVR was achieved in 87% of cases (96% vs 83% of patients with genotype 2/3 and 1/4, respectively; P < 0.001). The bivariate analysis showed that patients who failed to achieve EVR were older (P < 0.005), had higher ALT (P < 0.05), AST (P < 0.05), GGT (P < 0.001) and ferritin levels (P < 0.001), a diagnosis of cirrhosis (P < 0.001), and a higher baseline viral load (P < 0.05) than patients reaching an EVR. Age < 40 years [odds ratios (OR): 0.543, 95%CI: 0.373-0.790, P < 0.01], GGT < 85 IU/mL (OR: 3.301, 95%CI: 0.192-0.471, P < 0.001), low ferritin levels (OR: 0.999, 95%CI: 0.998-0.999, P < 0.01) and genotype other than 1/4 (OR: 4.716, 95%CI: 2.010-11.063, P < 0.001) were identified as independent predictors for EVR in the multivariate analysis. CONCLUSION: CHC patients treated with peginterferon-α-2a/ribavirin in clinical practice show high EVR. Older age, genotype 1/4, and high GGT were associated with lack of EVR. 展开更多
关键词 ANTIVIRAL therapy BASELINE FACTORS Early virological response peginterferon Α-2A ribavirin
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Twenty four-week peginterferon plus ribavirin after interferon-β induction for genotype 1b chronic hepatitis C 被引量:2
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作者 Hiroaki Okushin Kazuhiko Morii +1 位作者 Koichi Uesaka Shiro Yuasa 《World Journal of Hepatology》 CAS 2010年第6期226-232,共7页
AIM:To investigate the possibility of shortening the duration of peginterferon(Peg-IFN)plus ribavirin(RBV) combination therapy by incorporating interferon-β (IFN-β)induction therapy. METHODS:A one treatment arm,coho... AIM:To investigate the possibility of shortening the duration of peginterferon(Peg-IFN)plus ribavirin(RBV) combination therapy by incorporating interferon-β (IFN-β)induction therapy. METHODS:A one treatment arm,cohort prospective study was conducted on seventy one patients.The patients were Japanese adults with genotype 1b chronic hepatitis C,HCV-RNA levels of≥5.0 Log IU/mL or 100 KIU/mL,and platelet counts of≥90 000/μL.The treatment regimen consisted of a 2 wk course of twicedaily administration of IFN-βfollowed by 24 wk PegIFN plus RBV combination therapy.We prolonged the duration of the Peg-IFN plus RBV therapy to 48 wk if the patient requested it. RESULTS:The patients,including 44%males,were characterized by an median age of 63 years(range: 32-78 years),an median platelet count of 13.9(range: 9.1-30.6)×10 4 /μL,62%IFN-na?ve,and median HCV- RNA of 6.1(range:5.1-7.2)Log IU/mL.The sustained virologic response(SVR)rates were 34%(Peg-IFN:1-24 wk,n=61,95%confidence interval(CI): 24%-47%)and 55%(Peg-IFN:20-24 wk,n=31,95% CI:38%-71%,P<0.001;vs Peg-IFN:1-19 wk).TheSVR rate when the administration was discontinued early was 13%(Peg-IFN:1-19 wk,n=30,95%CI: 5%-30%),and that when the administration was prolonged was 50%(Peg-IFN:25-48 wk,n=10,95% CI:24%-76%,P<0.05;vs Peg-IFN:1-19 wk).In the patients who received 20-24 wk of Peg-IFN plus RBV,only the higher platelet count(≥130 000/μL) was significantly correlated with the SVR(odds ratio: 11.680,95%CI:2.3064-79.474,P=0.0024).In 45% (14/31)of the patients with a higher platelet count (≥130000/μL)before therapy,the HCV-RNA level decreased to below 3.3 Log IU/mL at the completion of IFN-β,and their SVR rate was 93%(13/14)after 20-24 wk administration of Peg-IFN plus RBV. CONCLUSION:These results suggest the possibilities of shortening the duration of Peg-IFN plus RBV combination therapy by actively reducing HCV-RNA levels using the IFN-βinduction regimen. 展开更多
关键词 peginterferon ribavirin INTERFERON-Β INDUCTION THERAPY Short-term THERAPY Chronic hepatitis C GENOTYPE 1b
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Efficacy of low dose peginterferon alpha-2b with ribavirin on chronic hepatitis C 被引量:10
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作者 Rajesh Gupta CH Ramakrishna +3 位作者 Sandeep Lakhtakia Manu Tandan Rupa Banerjee D Nageshwar Reddy 《World Journal of Gastroenterology》 SCIE CAS CSCD 2006年第34期5554-5556,共3页
AIM: To assess the effi cacy of peginterferon alpha 2b at doses of 50 μg weekly and 80 μg weekly (based on body weight) plus ribavirin in HCV genotype 2 and genotype 3 chronic hepatitis C patients. METHODS: During t... AIM: To assess the effi cacy of peginterferon alpha 2b at doses of 50 μg weekly and 80 μg weekly (based on body weight) plus ribavirin in HCV genotype 2 and genotype 3 chronic hepatitis C patients. METHODS: During the study period of Jan 2002 to Dec 2003, all patients diagnosed as chronic hepatitis C or HCV related compensated cirrhosis were treated with peginterferon alpha 2b 50 μg S/C weekly (body weight < 60 kg) or 80 μg S/C weekly (body weight > 60 kg) plus ribavirin 800 mg/d for 24 wk. RESULTS: Overall 28 patients, 14 patients in each group (based on body weight) were treated during the period. Out of 28 patients, 75% were genotype 3, 18% were genotype 2 and 7% were genotype 1. The mean dose of peginterferon alpha 2b was 0.91 μg/kg in group 1 and 1.23 μg/kg in group 2 respectively. The end of treatment and sustained virologic response rates were 82% and 78% respectively. Serious adverse effects were seen in 3.5% patients. CONCLUSION: Low dose peginterferon alpha 2b in combination with ribavirin for 24 wk is effective in HCV genotype 2 and 3 chronic hepatitis C patients. 展开更多
关键词 Chronic hepatitis C peginterferon alpha 2b ribavirin
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Long-term outcome of chronic hepatitis C patients with sustained virological response to peginterferon plus ribavirin 被引量:3
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作者 María Trapero-Marugán Jorge Mendoza +4 位作者 María Chaparro Leticia González-Moreno José Andrés Moreno-Monteagudo María Jesús Borque Ricardo Moreno-Otero 《World Journal of Gastroenterology》 SCIE CAS CSCD 2011年第4期493-498,共6页
AIM: To assess the clinical, biochemical and virological long-term outcome in chronic hepatitis C (CHC) patients with a sustained virological response (SVR) after peginterferon (PEG-IFN) plus ribavirin combination the... AIM: To assess the clinical, biochemical and virological long-term outcome in chronic hepatitis C (CHC) patients with a sustained virological response (SVR) after peginterferon (PEG-IFN) plus ribavirin combination therapy. METHODS: One hundred and fifty three patients with a SVR after treatment with PEG-IFN plus ribavirin were included in a 5-year follow-up study in a single Spanish center, based on standard clinical practice. Clinical anamnesis, biochemical analysis, hepatitis C virus RNA and alpha-fetoprotein measurement, ultrasonography and transient elastography were performed annually. RESULTS: The mean follow-up period of the 153 patients was 76 ± 13 mo after they obtained a SVR. Five patients (3.26%) presented with cirrhosis before treatment and 116 (75.8%) had genotype 1. No patient showed evidence of hepatic decompensation. One patient (0.65%) developed a hepatocellular carcinoma at month 30 after achieving SVR. There were no virological relapses during this follow-up period. Persistently elevated alanine aminotransferase was found in only one patient (0.65%). At the end of the 5-year follow-up, the mean value of transient elastography was 7 ± 4.3 kPa (F1). There were no deaths and no other tumors. CONCLUSION: The long-term outcome of 153 CHC patients with SVR to PEG-IFN plus ribavirin was good. No evidence of a virological relapse was seen. One patient (0.65%) developed a hepatocellular carcinoma. 展开更多
关键词 Chronic hepatitis C peginterferon ribavirin Sustained virological response Long-term effects
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Association of ITPA polymorphism with outcomes of peginterferon-α plus ribavirin combination therapy 被引量:1
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作者 Tatsuya Fujino Yoko Aoyagi +12 位作者 Mariko Takahashi Ryoko Yada Naoko Yamamoto Yuki Ohishi Akihiko Nishiura Motoyuki Kohjima Tsuyoshi Yoshimoto Kunitaka Fukuizumi Manabu Nakashima Masaki Kato Kazuhiro Kotoh Makoto Nakamuta Munechika Enjoji 《World Journal of Gastrointestinal Pharmacology and Therapeutics》 CAS 2013年第3期54-60,共7页
AIM:To analyzed the association between inosine triphosphatase(ITPA)(rs1127354) genotypes and sustained virological response(SVR) rates in peginterferon(Peg-IFN)α + ribavirin(RBV) treatment.METHODS:Patients who under... AIM:To analyzed the association between inosine triphosphatase(ITPA)(rs1127354) genotypes and sustained virological response(SVR) rates in peginterferon(Peg-IFN)α + ribavirin(RBV) treatment.METHODS:Patients who underwent Peg-IFNα + RBV combination therapy were enrolled(n = 120) and they had no history of other IFN-based treatments.Variation in hemoglobin levels during therapy,cumulative reduction of RBV dose,frequency of treatment withdrawal,and SVR rates were investigated in each ITPA genotype.RESULTS:In patients with ITPA CC genotype,hemoglobin decline was significantly greater and the percentage of patients in whom total RBV dose was < 60% of standard and/or treatment was withdrawn was significantly higher compared with CA/AA genotype.However,SVR rates were equivalent between CC and CA/AA genotypes,and within a subset of patients with Interleukin 28B(IL28B)(rs8099917) TT genotype,SVR rates tended to be higher in patients with ITPA CC genotype,although the difference was not significant.CONCLUSION:ITPA CC genotype was a disadvantageous factor for Peg-IFNα + RBV treatment in relation to completion rates and RBV dose.However,CC genotype was not inferior to CA/AA genotype for SVR rates.When full-length treatment is accomplished,it is plausible that more SVR is achieved in patients with ITPA CC variant,especially in a background of IL28B TT genotype. 展开更多
关键词 Chronic HEPATITIS C INTERLEUKIN 28B INOSINE triphosphatase peginterferon ribavirin
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Sudden hearing loss associated with peginterferon and ribavirin combination therapy during hepatitis C treatment 被引量:4
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作者 Héla Elloumi Fatma Houissa +4 位作者 Najet Bel Hadj Dalila Gargouri Malika Romani Jamel Kharrat AbdelJabbar Ghorbel 《World Journal of Gastroenterology》 SCIE CAS CSCD 2007年第40期5411-5412,共2页
Adverse effects associated with peginterferon and ribavirin during hepatitis C treatment are well known. Sudden hearing loss has rarely been reported. Possible mechanisms involved include direct ototoxicity of interfe... Adverse effects associated with peginterferon and ribavirin during hepatitis C treatment are well known. Sudden hearing loss has rarely been reported. Possible mechanisms involved include direct ototoxicity of interferon, autoimmunity, and hematological changes. Hearing loss is frequently fully resolved after discontinuation of antiviral therapy. We report a 47-year- old man with chronic hepatitis C, genotype 2 ac who developed sudden hearing loss 22 wk after starting therapy with peginterferon alpha 2a at a dose of 180 ~g per week and ribavirin 800 mg per day. Since symptoms did not worsen, antiviral therapy was continued for 2 wk, according to the patient's wish. Hearing loss resolved within 2 wk after the end of treatment. Serum liver alanine aminotransferase remained normal during and after the end of antiviral therapy. HCV RNA was undetectable at the end of therapy and remained negative 24 wk later. Thus, patients should be aware that hearing loss may occur with peginterferon therapy, but the decision whether to continue or to stop the treatment is based on the clinical judgment of the physician and the wishes of the patient. 展开更多
关键词 Adverse effects Hearing loss Hepatitis C INTERFERON ribavirin
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Peginterferon and ribavirin treatment for hepatitis C virus infection 被引量:16
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作者 Akihito Tsubota Kiyotaka Fujise +1 位作者 Yoshihisa Namiki Norio Tada 《World Journal of Gastroenterology》 SCIE CAS CSCD 2011年第4期419-432,共14页
Pegylated interferon α (IFNα) in combination with ribavirin is currently recommended as a standard-of-care treatment for chronic hepatitis C virus (HCV) infection. This combination therapy has drastically improved t... Pegylated interferon α (IFNα) in combination with ribavirin is currently recommended as a standard-of-care treatment for chronic hepatitis C virus (HCV) infection. This combination therapy has drastically improved the rate of sustained virological response, specifically in difficult-to-treat patients. Recently, individualized treatment, such as response-guided therapy, is being developed based on host-, HCV- and treatment-related factors. Furthermore, modified regimens with currently available medications, novel modified IFNα and ribavirin or combinations with specifically targeted antiviral therapy for HCV agents, are currently being investigated. The purpose of this review is to address some issues and epoch-making topics in the treatment of chronic HCV infection, and to discuss more optimal and highly individualized therapeutic strategies for HCV-infected patients. 展开更多
关键词 Pegylated interferon α ribavirin Chronic hepatitis C virus infection Difficult-to-treat patient Individualized treatment Response-guided therapy Specifically targeted antiviral therapy for hepatitis C virus
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Acute sensorineural hearing loss associated with peginterferon and ribavirin combination therapy during hepatitis C treatment: Outcome after resumption of therapy 被引量:2
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作者 Victor K Wong Cindy Cheong-Lee +1 位作者 Jo-Ann E Ford Eric M Yoshida 《World Journal of Gastroenterology》 SCIE CAS CSCD 2005年第34期5392-5393,共2页
Peginterferon and ribavirin combination therapy for the treatment of hepatitis C virus (HCV) is well known to be associated with significant adverse effects. Sensorineural hearing loss, that in most cases is unilate... Peginterferon and ribavirin combination therapy for the treatment of hepatitis C virus (HCV) is well known to be associated with significant adverse effects. Sensorineural hearing loss, that in most cases is unilateral, has been reported as a consequence of therapy with both non-pegylabed and pegylated interferon (pegIFN) but is not a well-known adverse effect. We report a 45-year-old Caucasian woman who developed acute sensorineural hearing loss 2 mo after starting therapy with pegIFN-α 2b and ribavirin for the treatment of chronic HCV, genotype la. She did not report the hearing loss to the hepatitis clinic until 1 mo, later whereupon therapy was promptly discontinued. Although her serum alanine aminotransferase (ALT) normalized and her HCV-RNA became undetectable after 12 wk of pegIFN and dbavirin therapy, after discontinuation, her HCV-RNA became detectable with significant elevations of serum ALT. Four months after initial discontinuation, the patient re-commenced pegIFN and ribavirin combination therapy. After 44 of 48 wk of therapy, the patient's liver biochemistry has normalized and the HCV-RNA is undetectable. She has not developed worsening of her hearing loss and hearing on the left-side is unaffected. Both patients and physicians should be aware that sensorineural hearing loss may occur with pegIFN therapy. Our experience suggests that re-institution of therapy is not always associated with further hearing impairment. 展开更多
关键词 peginterferon Hepatitis C Sensorineural hearing loss
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蓝芩口服液联合利巴韦林气雾剂对手足口病患儿症状恢复时间及病毒转阴率的影响
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作者 刘峰 蔡博 +1 位作者 李宝冬 王珂 《中国当代医药》 CAS 2024年第15期61-64,共4页
目的探讨蓝芩口服液联合利巴韦林气雾剂对手足口病患儿症状恢复时间及病毒转阴率的影响。方法选取2021年7月至2023年6月聊城市第二人民医院收治的96例手足口病患儿作为研究对象,按随机数字表法将其分为对照组(48例)和观察组(48例)。对... 目的探讨蓝芩口服液联合利巴韦林气雾剂对手足口病患儿症状恢复时间及病毒转阴率的影响。方法选取2021年7月至2023年6月聊城市第二人民医院收治的96例手足口病患儿作为研究对象,按随机数字表法将其分为对照组(48例)和观察组(48例)。对照组采用利巴韦林气雾剂治疗,观察组在对照组基础上采用蓝芩口服液治疗,两组均治疗2周。比较两组临床疗效、症状恢复时间、血清免疫球蛋白水平与病毒转阴率。结果观察组临床总有效率高于对照组,症状恢复时间及住院时间均短于对照组,观察组治疗后免疫球蛋白M(IgM)、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)水平高于对照组,观察组肠道病毒转阴率与人肠道病毒71型(EV71)病毒转阴率均高于对照组,差异有统计学意义(P<0.05)。结论在利巴韦林气雾剂基础上给予蓝芩口服液治疗能够显著提高临床疗效,快速缓解临床症状,改善免疫球蛋白水平,提升病毒转阴率。 展开更多
关键词 手足口病 蓝芩口服液 利巴韦林气雾剂 临床疗效 血清免疫球蛋白 肠道病毒 人肠道病毒71型
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索磷布韦/维帕他韦单用或联合利巴韦林治疗3B型HCV/HIV感染者的效果及安全性 被引量:4
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作者 刘立 常丽仙 +2 位作者 陈智勇 李俊义 刘春云 《临床肝胆病杂志》 CAS 北大核心 2024年第2期271-277,共7页
目的观察索磷布韦/维帕他韦单用或联合利巴韦林方案对我国基因3B型HCV/HIV感染者的治疗效果和安全性。方法选取2017年1月—2020年12月于昆明市第三人民医院就诊的3B型HCV/HIV合并感染者299例,使用索磷布韦/维帕他韦单用或联合利巴韦林治... 目的观察索磷布韦/维帕他韦单用或联合利巴韦林方案对我国基因3B型HCV/HIV感染者的治疗效果和安全性。方法选取2017年1月—2020年12月于昆明市第三人民医院就诊的3B型HCV/HIV合并感染者299例,使用索磷布韦/维帕他韦单用或联合利巴韦林治疗12周,停药后随访12周。评估治疗结束后12周的持续病毒学应答率(SVR12)和不良反应。计量资料两组间比较采用成组t检验或Mann-Whitney U检验。计数资料两组间比较采用χ^(2)检验。使用Agresti-Coull方法构建SVR12的95%CI。采用单因素和多因素非条件Logistic回归分析SVR的影响因素。结果299例3B型HCV/HIV感染者患者的平均年龄为(43.92±6.84)岁,男性占77.3%(231/299),肝硬化患者占36.5%(109/299),曾接受过抗病毒治疗者占13.4%(40/299),索磷布韦/维帕他韦联合利巴韦林治疗患者占27.8%(83/299)。患者总体SVR12为87.0%(260/299),其中索磷布韦/维帕他韦单用与联用利巴韦林SVR12比较,差异无统计学意义(87.5%vs 85.5%,χ^(2)=0.203,P=0.653);无肝硬化和肝硬化患者SVR12比较,差异有统计学意义(90.0%vs 81.7%,χ^(2)=4.256,P=0.039);抗病毒初治患者的SVR12明显高于经治患者(93.4%vs 45.0%,χ^(2)=71.670,P<0.001)。单因素和多因素Logistic回归分析结果显示,PLT(OR=0.957,95%CI:0.931~0.984,P=0.002)、肝硬度值(OR=1.446,95%CI:1.147~1.822,P=0.002)和经治(OR=13.807,95%CI:2.970~64.174,P=0.001)是3B型HCV/HIV感染者SVR的独立影响因素。出现严重不良反应事件41例,均在抗病毒治疗后2周内出现,28例在没有停药并积极处理后缓解;13例积极处理后仍未缓解,停用抗病毒药物2~5 d后缓解,缓解后再次使用未出现类似反应。结论索磷布韦/维帕他韦单用或联合利巴韦林对3B型HCV/HIV感染者有较好的治疗效果和安全性。 展开更多
关键词 肝炎病毒属 HIV 索磷布韦 维帕他韦 利巴韦林
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恩替卡韦联合聚乙二醇干扰素-α2b治疗代偿期乙型肝炎肝硬化患者疗效研究 被引量:1
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作者 李尧 梁健 +7 位作者 张春 董静 陈照林 周旭 娄方明 杨小康 刘波 宋海燕 《实用肝脏病杂志》 CAS 2024年第2期226-229,共4页
目的探讨应用恩替卡韦(ETV)联合聚乙二醇干扰素-α2b(Peg-IFN-α2b)治疗乙型肝炎肝硬化患者的近期疗效。方法2019年3月~2021年3月安徽医科大学附属巢湖医院诊治的代偿期乙型肝炎肝硬化患者78例,被随机分为对照组40例和观察组38例,分别给... 目的探讨应用恩替卡韦(ETV)联合聚乙二醇干扰素-α2b(Peg-IFN-α2b)治疗乙型肝炎肝硬化患者的近期疗效。方法2019年3月~2021年3月安徽医科大学附属巢湖医院诊治的代偿期乙型肝炎肝硬化患者78例,被随机分为对照组40例和观察组38例,分别给予ETV或ETV联合Peg-IFN-α2b治疗24 w,然后两组均继续接受ETV治疗,随访至48 w。常规检测肝功能指标、血清肝纤维化指标、血清HBV标志物定量和HBV DNA载量。结果在随访24 w末,观察组血清白蛋白水平为(45.7±3.2)g/L,显著高于对照组【(38.5±4.3)g/L,P<0.05】;观察组血清IV-C、HA、PⅢP和LN水平分别为(154.3±11.7)μg/L、(130.9±17.5)μg/L、(110.6±16.2)μg/L和(152.7±14.3)μg/L,均显著低于对照组【分别为(200.7±12.4)μg/L、(161.8±18.7)μg/L、(157.4±17.3)μg/L和(200.9±16.3)μg/L,P<0.05】;观察组血清HBsAg水平为1363.8(623.1,2767.6)IU/ml,显著低于对照组【2119.6(1144.9,5094.3)IU/ml,P<0.05】,而血清HBsAg阴转率为15.8%,显著高于对照组的0.0%(P<0.05)。结论联合应用ETV和Peg-IFN-α2b治疗代偿期乙型肝炎肝硬化患者可改善血清肝纤维化指标,提高血清HBsAg阴转率,可能有助于病情恢复。 展开更多
关键词 肝硬化 乙型肝炎 恩替卡韦 聚乙二醇干扰素-α2b 治疗
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Epidemic management in a measles outbreak in 2023,the return of vaccine-preventable diseases:A single center,retrospective observational study 被引量:2
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作者 Sevgi Aslan Tuncay Gulsen Akkoc +6 位作者 Seyhan Yilmaz Burcu Parlak Pinar Canizci Erdemli Aylin Dizi Isik Didem Buyuktas Aytac Meryem Cagla Abaci Capar Eda Kepenekli Kadayifci 《Asian Pacific Journal of Tropical Medicine》 SCIE CAS 2024年第3期110-118,共9页
Objective:To investigate the importance of immunization in preventing measles infection and to determine the most useful laboratory tests for confirmation of measles.Methods:This study included pediatric cases evaluat... Objective:To investigate the importance of immunization in preventing measles infection and to determine the most useful laboratory tests for confirmation of measles.Methods:This study included pediatric cases evaluated with a presumed diagnosis of measles between December 2022 and June 2023,at Marmara University Pendik Training and Research Hospital.The effects of vaccination status and underlying disease on the clinical course,treatments,and complications were evaluated.Results:In total,117 patients were enrolled in the study with a median age of 80 months(IQR:32.5-125.0).Twelve patients with contact history were asymptomatic and had an underlying disorder,and intravenous immunoglobulin was given to them for post-exposure prophylaxis.Fifty-one patients had confirmed measles diagnosis.Ribavirin treatment was given to three patients(a newborn,a girl with rhabdomyosarcoma,and a healthy boy)with respiratory distress.Seventy-eight percent of confirmed measles cases were unvaccinated,and all hospitalized cases were unvaccinated or under-vaccinated.Four full-vaccinated children had confirmed measles infection.Measles PCR from nasopharyngeal swabs was negative in all of them,and their diagnosis was established with anti-measles IgM positivity.Conclusions:The measles vaccine is the most effective way to protect from measles and measles-related complications.Although measles can also occur in fully vaccinated patients,the disease is milder than in unvaccinated patients.Using ELISA and RT-PCR tests together may be beneficial in patients with high clinical suspicion for early diagnosis. 展开更多
关键词 MEASLES OUTBREAK VACCINATION Vitamin A ribavirin
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聚乙二醇干扰素α-2b联合恩替卡韦治疗HBeAg阳性慢性乙型肝炎患者疗效研究
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作者 彭麟 杨春 李兴泉 《实用肝脏病杂志》 CAS 2024年第5期677-680,共4页
目的观察比较聚乙二醇干扰素α-2b(Peg-IFN-α)联合恩替卡韦治疗血清HBeAg阳性的慢性乙型肝炎(CHB)患者的疗效。方法2019年1月~2022年1月我院收治的279例血清HBeAg阳性的CHB患者,被分为3组,每组93例,分别给予恩替卡韦口服治疗、Peg-IFN... 目的观察比较聚乙二醇干扰素α-2b(Peg-IFN-α)联合恩替卡韦治疗血清HBeAg阳性的慢性乙型肝炎(CHB)患者的疗效。方法2019年1月~2022年1月我院收治的279例血清HBeAg阳性的CHB患者,被分为3组,每组93例,分别给予恩替卡韦口服治疗、Peg-IFN-α皮下注射治疗或恩替卡韦联合Peg-IFN-α治疗,均持续治疗48 w,评估疗效。常规检测血清生化学、血清学和病毒学指标。结果在治疗48 w末,联合组HBeAg转阴率和HBeAg血清转换率分别为32.3%和21.5%,Peg-IFN-α治疗组分别为22.6%和15.1%,而恩替卡韦治疗组则无血清HBeAg转阴或HBeAg血清转换者,联合组尚有一些零星的病例发生HBsAg转阴(3.2%)或HBsAg血清转换(2.2%);联合组血清HBsAg和HBeAg水平分别为(1.9±0.3)lg s/co和(0.5±0.1)lg s/co,Peg-IFN-α治疗组分别为(2.2±0.2)lg s/co和(0.6±0.1)lg s/co,均显著低于恩替卡韦治疗组【分别为(3.6±0.2)lg s/co和(1.3±0.2)lg s/co,P<0.05】,而联合组和恩替卡韦治疗组血清HBV DNA载量均显著低于Peg-IFN-α治疗组(P<0.05);联合组血清ALT和AST水平分别为(30.9±4.5)U/L和(28.4±5.3)U/L,恩替卡韦治疗组分别为(31.5±3.6)U/L和(32.3±4.7)U/L,均显著低于Peg-IFN-α治疗组【分别为(48.1±4.2)U/L和(42.7±5.0)U/L,P<0.05】。结论联合应用恩替卡韦和Peg-IFN-α治疗血清HBeAg阳性的CHB患者可能获得更好的血清学转换率,在优势人群可能获得功能性治愈,值得深入研究。 展开更多
关键词 慢性乙型肝炎 聚乙二醇干扰素Α-2B 恩替卡韦 治疗 功能治愈
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抗病毒药物利巴韦林降解菌群的富集:微生物群落结构、降解特征及机理
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作者 李紫辉 何欢 +5 位作者 郭子维 杨世承 熊金瑞 黄斌 张皓东 潘学军 《环境科学研究》 CAS CSCD 北大核心 2024年第9期2064-2073,共10页
利巴韦林(RBV)是一种可针对多种RNA和DNA病毒的广谱抗病毒药物。但人体对RBV的低吸收率导致约60%的RBV以排泄物的方式排出体外,造成水体污染。微生物降解是目前常用的环境修复技术,但鲜见关于RBV降解菌群或菌株的报道。本研究从活性污... 利巴韦林(RBV)是一种可针对多种RNA和DNA病毒的广谱抗病毒药物。但人体对RBV的低吸收率导致约60%的RBV以排泄物的方式排出体外,造成水体污染。微生物降解是目前常用的环境修复技术,但鲜见关于RBV降解菌群或菌株的报道。本研究从活性污泥中富集提取了一种可以有效降解RBV的微生物群落,并基于16S rRNA测序数据对菌群结构进行了详细描述。富集菌群可以在3天内降解97.24%的RBV(初始浓度为5.0 mg/L),生物降解过程符合一级动力学方程(R^(2)>0.96)。此外,它们能在弱酸性、中性的pH范围(5.0~7.0)和中高温(35.0~40.0℃)下保持较高的降解性能。在RBV降解过程中,共检测到7种可能的中间产物并基于此构建了RBV生物降解途径。降解产物的急性毒性实验表明,RBV经过生物降解后其毒性降低。富集菌群中丰度较高的变形杆菌属和克雷伯氏菌属可能在RBV生物降解中发挥潜在作用。碳氮裂解酶、ABC转运蛋白和异种生物的生物降解及代谢相关的基因可能与RBV生物降解有关。本研究为RBV的防控提供了一种可行的生物降解方法。 展开更多
关键词 利巴韦林(RBV) 生物降解 微生物群落 降解产物和途径 宏基因组学
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肌苷单磷酸脱氢酶在卵清蛋白诱导过敏性哮喘中的作用
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作者 桑碧敏 孔春雪 +6 位作者 曹静蕾 梁景仪 卢芳菲 张国薇 李金泉 李平 周婷 《华中科技大学学报(医学版)》 CAS CSCD 北大核心 2024年第5期578-585,共8页
目的探讨肌苷单磷酸脱氢酶(inosine monophosphate dehydrogenase,IMPDH)在卵清蛋白(ovalbumin,OVA)诱导过敏性哮喘发生发展中的作用。方法将36只BALB/c雌性小鼠随机分为健康对照组、OVA哮喘组和IMPDH抑制剂(利巴韦林)干预组,每组12只... 目的探讨肌苷单磷酸脱氢酶(inosine monophosphate dehydrogenase,IMPDH)在卵清蛋白(ovalbumin,OVA)诱导过敏性哮喘发生发展中的作用。方法将36只BALB/c雌性小鼠随机分为健康对照组、OVA哮喘组和IMPDH抑制剂(利巴韦林)干预组,每组12只。收集每只小鼠的肺泡灌洗液(bronchoalveolar lavage fluid,BALF)、肺组织、外周血及脾脏,采用苏木精-伊红染色分析肺组织病理改变,免疫组织化学法检测肺组织内CD3的表达情况,血球分析仪检测BALF和外周血中白细胞总数及分类计数,qRT-PCR和Western blot分别检测肺组织IMPDH mRNA和蛋白表达水平,免疫荧光法检测肺组织IMPDH蛋白定位和表达情况,流式细胞术检测外周血和脾脏淋巴细胞亚群及其细胞内IMPDH蛋白表达水平。结果与健康对照组相比,OVA哮喘组小鼠肺内小气道周围及肺泡间隔大量炎症细胞浸润,BALF和外周血中白细胞总数均显著增加,以中性粒细胞、嗜酸性粒细胞和单核细胞的数量增多为主(均P<0.05),且肺组织内IMDPH蛋白水平显著升高(P<0.05),炎症细胞胞质内明显增多的IMPDH蛋白呈分散模式。给予利巴韦林干预后哮喘小鼠肺部炎症明显减轻,尤以BALF中嗜酸性粒细胞和中性粒细胞显著减少为特征(均P<0.05),同时肺部IMPDH蛋白水平降低(P<0.05),炎症细胞胞质内IMPDH表达减少,但细胞核内出现较多IMPDH丝状结构。此外,OVA哮喘组小鼠脾脏中B细胞占比明显增多(P<0.05),但利巴韦林干预后哮喘小鼠脾脏中B细胞占比显著减少,而NK、CD3^(+)T和CD8^(+)T细胞占比较OVA哮喘组明显增高(均P<0.05)。同时利巴韦林干预组脾脏NK细胞内IMPDH蛋白表达水平较健康对照组升高,而CD8^(+)T细胞内IMPDH蛋白表达水平降低。结论抑制IMPDH可有效缓解以啫酸性粒细胞为主的气道及全身炎症反应,同时还能降低脾脏B细胞免疫应答,增强NK及CD8^(+)T细胞等杀伤细胞的免疫应答效应,其潜在的机制可能与炎症细胞内IMPDH表达量及其形成的丝状结构有关。 展开更多
关键词 肌苷单磷酸脱氢酶 过敏性哮喘 气道炎症 淋巴细胞 利巴韦林
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肝移植受者戊型肝炎病毒感染
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作者 郭藩盛 曾强 窦剑 《器官移植》 CAS CSCD 北大核心 2024年第3期352-358,共7页
戊型肝炎病毒感染是急性病毒性肝炎的常见病因。近年来,戊型肝炎发病率呈上升趋势,逐渐成为世界范围内急性病毒性肝炎的重要病因。年龄、性别、免疫抑制强度、经济社会因素均是戊型肝炎病毒感染的危险因素。肝移植受者术后需长期应用免... 戊型肝炎病毒感染是急性病毒性肝炎的常见病因。近年来,戊型肝炎发病率呈上升趋势,逐渐成为世界范围内急性病毒性肝炎的重要病因。年龄、性别、免疫抑制强度、经济社会因素均是戊型肝炎病毒感染的危险因素。肝移植受者术后需长期应用免疫抑制药进行抗排斥反应治疗,处于免疫抑制状态,易感染戊型肝炎病毒且有引起肝纤维化及肝硬化的风险。因此,在临床工作中应重点关注肝移植受者,同时应进一步明确相关危险因素,以便辅助诊断和采取更严格的预防措施。本文根据现有文献对戊型肝炎病毒病原学特点以及肝移植受者戊型肝炎病毒感染的流行病学特征、临床表现、诊断及治疗进行综述,以期在临床上更好地对肝移植受者戊型肝炎病毒感染进行监测、治疗及预防,改善肝移植受者的预后。 展开更多
关键词 戊型肝炎病毒 肝移植 流行病学特征 慢性戊型肝炎 肝纤维化 肝硬化 利巴韦林 持续病毒学应答
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热毒宁注射液治疗≤14岁儿童急性呼吸道感染不良反应的Meta分析
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作者 张跃 杨婷婷 凌建春 《实用医技杂志》 2024年第1期58-64,共7页
目的 分析≤14岁患儿热毒宁注射液治疗急性上呼吸道感染随机对照研究不良反应Meta评价。方法 采用计算机检索中国知网(CNKI)、万方数据库(Wanfang)、维普科技期刊全文数据库、中国生物医学文献服务系统(SinoMed)、PubMed、EMBASE、Cochr... 目的 分析≤14岁患儿热毒宁注射液治疗急性上呼吸道感染随机对照研究不良反应Meta评价。方法 采用计算机检索中国知网(CNKI)、万方数据库(Wanfang)、维普科技期刊全文数据库、中国生物医学文献服务系统(SinoMed)、PubMed、EMBASE、Cochrane Central Register of Controlled Trials、MEDLINE数据库,检索时间为建库至2022年4月,筛选热毒宁注射液治疗上呼吸道感染的临床研究。结果 纳入17篇随机对照试验(RCT)文献进行Meta分析,其中试验组(热毒宁注射液)1 043例,对照组(利巴韦林注射液)1 042例。14篇报告不良反应的文献Meta分析显示:2组总体还是以恶心呕吐、上腹部不适、腹泻、皮疹等不良反应为主,其中热毒宁注射液(试验组)引起恶心呕吐15例、上腹部不适6例、腹泻12例、皮疹3例;利巴韦林注射液(对照组)引起恶心呕吐38例、上腹部不适20例、腹泻10例、皮疹26例,此外利巴韦林注射液还引起患儿白细胞减少18例、其他不良反应6例。热毒宁注射液(试验组)引起的不良反应的危险度总体低于利巴韦林注射液(对照组)[OR值(95%CI)=0.27(0.19,0.40),Z=6.583,P<0.001];总体不良反应以恶心呕吐、上腹部不适、腹泻、皮疹等为主。研究还发现,热毒宁注射液(试验组)总体有效率高于利巴韦林注射液(对照组)[OR值(95%CI)=5.00(3.46,7.22),Z=8.582,P<0.001]。结论 热毒宁注射液总体不良反应以恶心呕吐、上腹部不适、腹泻、皮疹等为主,总体安全性较好、有效性较高,但需进一步纳入高质量随机对照研究为临床提供循证依据。 展开更多
关键词 热毒宁注射液 利巴韦林注射液 不良反应 有效率 META分析
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Advances in immunotherapy for hepatitis B virus associated hepatocellular carcinoma patients
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作者 Wei-Hua Cao Ya-Qin Zhang +2 位作者 Xin-Xin Li Zi-Yu Zhang Ming-Hui Li 《World Journal of Hepatology》 2024年第10期1158-1168,共11页
Hepatitis B virus(HBV)infection plays an important role in the occurrence and development of hepatocellular carcinoma(HCC),and the rate of HBV infection in liver cancer patients in China is as high as 92.05%.Due to lo... Hepatitis B virus(HBV)infection plays an important role in the occurrence and development of hepatocellular carcinoma(HCC),and the rate of HBV infection in liver cancer patients in China is as high as 92.05%.Due to long-term exposure to chronic antigens from the gut,the liver needs to maintain a certain level of immune tolerance,both to avoid severe inflammation caused by non-pathogenic antigens and to maintain the possibility of rapid and violent responses to infection and tumors.Therefore,HBV infection interacts with the tumor microenvironment(TME)through a highly complex and intertwined signaling pathway,which results in a special TME in HCC.Due to changes in the TME,tumor cells can evade immune surveillance by inhibiting tumor-specific T cell function through cytotoxic T-lymphocy-associated protein-4(CTLA-4)and programmed cell death 1(PD-1)/programmed cell death ligand 1(PD-L1).Interferons,as a class of immune factors with strong biological activity,can improve the TME of HBV-HCC through various pathways.In recent years,the systematic treatment of HCC has gradually come out of the dilemma.In addition to the continuous emergence of new multi-target anti-vascular tyrosine kinase inhibitor drugs,immune checkpoint inhibitors have opened up a new avenue for the systematic treatment of HCC.At present,immunotherapy based on PD-1/L1 inhibitors has gradually become a new direction of systematic treatment for HCC,and the disease charac-teristics of patients included in global clinical studies are different from those of Chinese patients.Therefore,whether a group of HCC patients with HBV background and poor prognosis in China can also benefit from immunotherapy is an issue of wide concern.This review aims to elucidate the advances of immuno-therapy for HBV related HCC patients with regard to:(1)Immunotherapy based on interferons;(2)Immunotherapy based on PD-1/L1 inhibitors;(3)Immunotherapy based on CTLA4 inhibitors;(4)Adoptive cell transfer;(5)Combination immunotherapy strategy;and(6)Shortcomings of immunotherapy. 展开更多
关键词 Hepatitis B virus Hepatocellular carcinoma Immune checkpoint inhibitors peginterferon alpha Systematic treatment
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