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Objective To study the clinical efficacy of pegylated interferon α-2a(PEG-IFN α-2a) and ribavirin combined with self-extracting traditional Chinese medicine(TCM) in the treatment of chronic hepatitis C(CHC) of gan-shen yin-deficiency and damp-heat syndrome.Methods A total of 59 cases of CHC of gan-shen yin-deficiency and damp-heat syndrome confirmed in our hospital was randomly divided into control group(n=29) and combined group(n=30).The patients in both groups were treated with PEG-IFN α-2a injection and ribavirin,and then the self-extracting TCM was added on the patients in combined group.The differences of quantitative score,improvement of liver function,RNA negative rate of HCV,the levels of IL-21,IL-6 and TNF-α,clinical treatment of total efficiency and adverse reactions were compared between the two groups before and after treatment.Results After treatment,the quantitative scores of TCM symptoms(rib-side pain,soreness and weakness of waist and knees,abdominal distension,red tongue with yellowish fur,dizziness with heavy body,insomnia and dreaminess) in combined group were significantly lower than those in control group(P＜0.05),but the difference of quantitative scores of other TCM symptoms between the two groups was not statistically significant(P＞0.05);The levels of alanine aminotransferase(ALT),aspartate aminotransferase (AST) and total bilirubin(TBIL) in combined group were better than those in control group(P＜0.05) after 48 weeks of treatment,but the difference of the levels of albumin(ALB) and glutamyl transpeptidase(GGT) were norstatistically significant in both groups(P＞0.05);The RNA negative rate of HCV in combined group was significantly higher than that in control group after 36-week or 48-week treatment(P＜0.05),but there was no statistically significant difference between the two groups after 12-week or 24-week treatment and 24-week follow-up;The levels of TNF-α,IL-17,IL-23 in combined group were significantly lower than those in control group(P＜0.05) after 48 weeks of treatment;The total efficiency of combined group is better than that of control group (93.33％ vs.72.41％,P＜0.05).There was no significant difference in adverse reactions between the two groups(P＞0.05).Conclusion The application of PEG-IFN α-2a and ribavirin combined with the self-extracting TCM in the treatment of CHC can obviously ameliorate the clinical symptoms and liver function indexes,improve the RNA negative rate of HCV,reduce the levels of inflammatory factors,and improve the clinical efficacy.
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BACKGROUND/AIMS: Several studies have demonstrated that serum interferon-γ-inducible-protein-10 (IP-10) levels at baseline and single nucleotide polymorphisms (SNPs) near the IL28B gene were associated with viral response and treatment outcomes. Our purpose was to assess the combination of pretreatment IP-10 levels with IL28B SNPs as predictors of treatment response to pegylated interferon α-2a plus ribavirin in patients infected with genotype 1 hepatitis C virus in China. METHODS: Seventy-two patients with chronic hepatitis C without fibrosis/cirrhosis were enrolled in the study. The virologic parameters and baseline serum IP-10 levels were determined. IL-28B genotypes were determined by sequencing. RESULTS: In this cohort, serum baseline IP-10 levels lower than 426.7 pg/mL could predict rapid virological response/sustained virological response (SVR). Patients carrying favorable IL28B SNP genotypes had higher SVRs than did those carrying unfavorable variants (IL28B rs12979860, p=0.002; IL28B rs8099917, p=0.020). Combining both baseline IP-10 and IL28B SNPs could improve the prediction of SVR in favorable allele carriers of IL28B, rs12979860 CC and rs8099917 TT. Serum baseline IP-10 levels and IL28B genotypes were independent predictors of SVR. CONCLUSIONS: Our study shows that the combination of baseline serum IP-10 levels and the determination of IL28B SNPs increase the predictability of SVR rates in this cohort.
Subject(s)
Humans , Alleles , China , Cohort Studies , Genotype , Hepacivirus , Hepatitis C , Hepatitis C, Chronic , Hepatitis , Interferons , Polymorphism, Single Nucleotide , RibavirinABSTRACT
Objective To research the clinical curative effect of pegylated interferon α-2a (Peg-IFNα-2a) combined with ribavirin in treating chronic hepatitis C with positive autoantibodies.Methods The autoantibodies were screened in 93 cases of chronic hepatitis C patients and then the patients were divided into positive group and negative group.Both of the two groups were given therapy with Peg-IFN α-2a combined with ribavirin.The capacity of hepatitis C virus (HCV) RNA,virological response rate,and blood concentration of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were quantified before and in the process of treatment.Results Twenty-eight patients had autoantibodies,with 17 patients of antimitochondrial antibody,8 patients of anti smooth muscle antibody and 3 patients of anti-liver-kidney microsomal antibody-1.The quantity of HCV RNA and the virological response rate had no significant difference before and after treatment (P ＞ 0.05).The concentration of ALT and AST in positive group were higher than those in negative group before and in the process of treatment,while there were obvious differences only after 36 weeks of treatment (P ＜ 0.05).Conclusion Peg-IFN α-2a combined with ribavirin is effective for chronic hepatitis C for all the patients,but liver function of autoantibody negative patients have a better recovery.
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Objective To invetigate the feature of Th 17 cells in chronically HBV-infected patients whole responsed to pegylated interferon α-2a treatment.Methods Serum and PBMCs were obtained from enrolled CHB patients and health controls and monitored for ALT , HBV DNA, HBV Markers as well as the frequency of IL-17 +T cells.Results The frequency of IL-17 +,IL-17 +IFN-γ+and IL-17 +IFN-γ-T cells increased in whole response time point and decreased in followed 6 month ;and lower than that of health controls at any group .Conclusion Tteatment with pegylated interferon α-2a minght effect the fre-quency and composition of Th 17 cells, which effect the immune regulation in the disease .