| Objective Objective to investigate the long-term efficacy and prognostic factors of chronic hepatitis C(CHC)treated with interferon.Methods In a retrospective statistical analysis of disease clinic data of199 cases of CHC with Data integrity in the First Affiliated Hospital of Guangxi Medical University,the observation time is more than 1 years.And the patients were treated with antiviral therapy(T group),and the patients without antiviral therapy were included in the untreated group(UT group).And observe the incidence of liver cirrhosis and liver cancer,the cumulative incidence and its influencing factors,and to compare the incidence rate of two groups of patients with liver cirrhosis,liver cancer have similarities and differences,incorporating gender,age,fatty liver,diagnostic time,different year of infection,infection,baseline serum HCVRNA viral load,HCV genotypes,treatment options,virological and serological liver function and so on into the influential factors were statistically analyzed.Results 1.The median follow-up median of 199 patients with chronic hepatitis c was 4 years,the shortest was 1 year,and the longest was 15 years.Among them,112 cases were treated with interferon combined with ribavirin,87 cases were not treated with antiviral therapy.There were 112 cases in the treatment group,including 64 males and 48 females,aged(44.58±13.02)years.There were 87 cases in the untreated group,including 45 males and 42 females,with an average age of(52.38±11.46)years.2.of all 50 patients(50/199,25.1%)found liver cirrhosis or liver cancer,and 16 of the treatment group(16/112,14.3%)progressed to liver cirrhosis or liver cancer,of which 15 were progressed to cirrhosis(15/112,13.4%)and 1were progressed to liver cancer(1/112,0.9%).In the non treatment group,34(34/87,39.1%)found liver cirrhosis or liver cancer,22 patients progressed to cirrhosis(22/87,25.3%),and 12 cases were liver cancer(12/87,13.8%).The incidence of cirrhosis and liver cancer decreased significantly after antiviral therapy(P<0.05).2.1 The cumulative incidence of cirrhosis for first,2,3,and 4,5,5-10,10 years in the treatment group was 3.6%,4.5%,7.1%,8%,11.6%,13.4%.Only one patient in the treatment group was found to have liver cancer after 2 years of follow-up,and no hepatocellular carcinoma occurred during the follow-up of 3years and later.2.2 There were 87 cases of chronic hepatitis C in the untreated group.The cumulative incidence of cirrhosis for first,2,3,4,5,5-10,10,and after the follow-up was 8.0%,13.8%,16.1%,17.2%,20.7%,24.1%,25.3%,respectively,and the cumulative incidence of hepatitis C related liver cancer,years,years,years,years,and later.The cumulative incidence of hepatitis C associated liver cancer for first,2,3,4,5,5-10,10,and 10 years were 1.1%,6.9%,9.2%,11.5%,11.5%,12.6%,13.8%.3.Treatment group application peg-interferon plus ribavirin treatment of 31cases(31/40,77.5%)get sustained virological response(SVR),the application ofordinary interferon plus ribavirin in 41 cases(41/72.56.9%)get sustained virological response(SVR).polyethylene glycol interferon(Peg IFN)than interferon(IFN)high SVR rate(P < 0.05).4.64 patients with gene 1b type,10 cases(15.6%)of liver cancer,45 cases of non 1B gene,1 cases of liver cancer(2.2%),gene 1b more easily progressing to liver cancer(P<0.05)than non 1b type,21 cases of liver cirrhosis(32.8%),gene non 1b type,8 cases of liver sclerosis(17.8%),Genotyping has little to do with the progression of cirrhosis.(P>0.05).5.Over 50 years of age is an independent risk factor for the progression of chronic hepatitis C.Antiviral therapy is a protective factor for the progression of chronic hepatitis C.6.The total recurrence rate of CHC was4.2%,8.3%,9.7%,12.5% after first,2,3 and 5 years.Conclusion: 1.Interferon + ribavir-antiviral therapy can reduce the incidence of CHC cirrhosis and liver cancer.2.The combination of polyethylene glycol interferon and ribavirin regimen was associated with a higher SVR rate than the interferon combined with ribavirin.3.Patients with type 1b CHC were more likely to deelop liver cancer than non-1b patients.4.Age ?50 is an independent risk factor for progression of chronic hepatitis c. |
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