METHODS: The study involved 35 HCV patients (mean age: 56.23 ± 1.45) divided into two groups. Group 1 included 15 HCV + HCC patients and Group 2 included 20 HCV non-HCC patients.
RESULTS: At the end of treatment all the patients were HCV RNA negative. Three months after the end of antiviral treatment, HCV RNA was undetectable in all patients, while a complete biochemical and virological response was observed in 66.7% of HCV + HCC patients and 85.0% of HCV non-HCC patients. PIVKA-II levels before the initiation of antiviral treatment were high in all patients. At the end of the treatment, in the HCV non-HCC group, normalization of PIVKA-II levels was observed only in 20.0% cases, and in 60.0% of cases 3 months after the treatment. Meanwhile, in patients with HCC and chronic HCV, PIVKA-II levels were within the normal range 3 months after treatment in only 13.3% of patients.
CONCLUSIONS: It is necessary to monitor HCV patients with cirrhosis (F4) and severe fibrosis (F3) without HCC, who have high PIVKA-II and AFP levels and/or ALT activity despite obtaining sustained virologic response 3 months after treatment with DAAs.
方法:本研究涉及35例HCV患者(平均年龄:56.23±1.45),分为两组。第1组包括15名HCV+HCC患者,第2组包括20名HCV非HCC患者。
结果:治疗结束时,所有患者均为HCVRNA阴性。抗病毒治疗结束三个月后,所有患者都检测不到HCVRNA,而在66.7%的HCV+HCC患者和85.0%的HCV非HCC患者中观察到完整的生化和病毒学应答。在开始抗病毒治疗之前,所有患者的PIVKA-II水平都很高。在治疗结束时,在HCV非HCC组中,仅在20.0%的病例中观察到PIVKA-II水平正常化,60.0%的病例在治疗后3个月。同时,在HCC和慢性HCV患者中,仅13.3%的患者在治疗后3个月PIVKA-II水平在正常范围内。
结论:有必要监测无HCC的肝硬化(F4)和严重纤维化(F3)的HCV患者,尽管在使用DAA治疗3个月后获得持续的病毒学应答,但仍具有较高的PIVKA-II和AFP水平和/或ALT活性。