Dynamic changes and clinical significance of inflammatory factors in patients with chronic hepatitis C after antiviral therapy
Objective To analyze the dynamic changes and clinical significance of inflammatory factors in patients with chronic hepatitis C(hereinafter referred to as hepatitis C)undergoing antiviral therapy,and provide experience guidance for antiviral therapy.Methods The patients with chronic hepatitis C who were prospectively included in the hospital from January 2019 to January 2021 were treated with antiviral drugs for 24 weeks.The serum levels of interleukin-10(IL-10)and interleukin-18(IL-18)were measured before treatment and at the 8th,12th and 24th weeks after treatment.The patients were followed up for 1 year after treatment.The inci-dence of liver cirrhosis during the follow-up period was counted,and the relationship between the dynamic changes of serum IL-10,IL-18 and liver cirrhosis in patients with chronic hepatitis C antiviral therapy was analyzed.Results A total of 98 patients with chronic hepatitis C were enrolled in this study,and 95 patients completed standard treatment for 24 weeks as required.The follow-up results showed that 15 of 95 patients(15.79％)developed cirrhosis.Hepatitis C virus RNA(HCV-RNA),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin levels in cirrhosis group were higher than those in non-cirrhosis group,with a statistically significant difference(P＜0.05).The levels of IL-10 and IL-18 in serum of cirrhosis group and non-cirrhosis group at 8,12 and 24 weeks after treatment were lower than those before treatment,and the levels of IL-10 and IL-18 in non-cirrhosis group were lower than those in cirrhosis group,with a statistically significant difference(P＜0.05).There was no statistically significant differ-ence in serum IL-10 and IL-18 levels between the two groups before treatment(P＞0.05).The point binary correlation analysis showed that the serum IL-10 and IL-18 levels at the 8th,12th and 24th weeks of treatment were positively correlated with the occur-rence of liver cirrhosis in patients with chronic hepatitis C antiviral treatment(r＞0,P＜0.05).The ROC curve of the subjects was drawn.The results showed that the area under the curve(AUC)predicted by serum IL-10 and IL-18 at 8,12 and 24 weeks of treatment in patients with chronic hepatitis C treated with antiviral therapy was greater than 0.7,which had certain predictive value,and the se-rum IL-10 and IL-18 at 24 weeks of treatment had the best predictive value.Conclusion The dynamic changes of serum IL-10 and IL-18 are closely related to liver cirrhosis in patients with chronic hepatitis C treated with antiviral therapy,and have a high predictive value for the effect of antiviral therapy.
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