Clinical features of antiviral therapy in 12 patients with hepatitis C virus-related cirrhosis after splenectomy / 中华肝脏病杂志

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the therapeutic effects and influencing factors of common antiviral therapy (low-dose interferon plus ribavirin, IFN+RBV) in patients with hepatitis C virus (HCV)-decompensated cirrhosis following splenectomy.</p><p><b>METHODS</b>Twelve patients were treated post-surgery with low-dose IFN (300-500 MIU QOD) or pegylated (Peg)-IFN (50 mug/w) and RBV (0.6-0.9 g/d) for 72 weeks if carrying the lb genotype or 48 weeks if carrying the 2a genotype. All patients were followed-up for 24 weeks after treatment completion to determine the virological response (VR) rates, measured as rapid (R)VR, complete early (cE)VR, 24 hr (24)VR, and sustained (S)VR. Statistical comparisons were made using the t-test or rank sum test, and correlation analyses were made using the Chi-square test. Differences were considered significant at P less than 0.05.</p><p><b>RESULTS</b>All 12 patients completed the treatment course and follow-up. Three patients could not tolerate the Peg-IFN and were switched to IFN, and six patients developed hemolysis that required RBV dose adjustment. The VR rates were 25.0%, RVR; 50.0%, cEVR; 16.7%, 24VR; 86.0%, SVR. Only one patient was a non-responder, and only one relapsed. Of the patients who achieved SVR, 100% had shown RVR, 83.3% showed cEVR, and 50.0% showed 24VR, suggesting that RVR and cEVR may effectively predict SVR.</p><p><b>CONCLUSION</b>Some HCV-decompensated cirrhosis patients may benefit from antiviral therapy following surgical resolution of hypersplenism. The occurrence of RVR and cEVR in these patients is positively correlated with achieving SVR. Physician-patient communication during early antiviral treatment and close clinical monitoring accompanied by psychological counseling throughout promotes success of the treatment approach.</p>