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2017, vol. 145, br. 1-2, str. 43-48
Autoimunska bolest štitaste žlezde kod obolelih od hroničnog hepatitisa C lečenih pegilovanim intereferonom alfa i ribavirinom - prospektivna studija
aKlinički centar Vojvodine, Klinika za infektivne bolesti, Novi Sad
bKlinički centar Vojvodine, Klinika za endokrinologiju, dijabetes i bolesti metabolizma, Novi Sad
cUniverzitet 'Magna Gracia', Odeljenje zdravstvenih nauka, Katancaro, Italija
Ključne reči: hronični hepatitis C; autoimunska bolest štitnjače; pegilovani interferon alfa; ribavirin
Sažetak
Uvod/Cilj Uprkos nedovoljno razjašnjenom patofiziološkom mehanizmu razvoja, danas je autoimunska bolest štitaste žlezde prepoznata kao jedna od ektrahepatičnih manifestacija hronične HCV infekcije. Cilj studije je da se utvrde kliničke karakteristike i da se proceni uspeh terapije pegilovanim interferonom -α2a i ribavirinom (pegIFN-α2a + RBV) kod obolelih od hroničnog hepatitisa C (HHC) sa autoimunskom bolešću štitnjače, kao njenom ektrahepatičnom manifestacijom. Metode Prospektivna studija je obuhvatila 91 obolelog od HHC lečenog IFN-α2a + RBV od 2010. do 2012. (39 žena i 52 muškaraca, prosečne starosti 41,6 ± 11.9). Ispitivanu grupu (grupu A) činilo je 31 obolelih od CHC i AITD. Kontrolnu gropu (grupu B) činilo je 60 obolelih od HHC bez AITD. Analizirani su klinički, biohemijski, virusološki i histopatološki markeri CHC, odgovor i pojava neželjenih dejstava na terapiju pegIFN-α2a + RBV. Rezultati Između posmatranih grupa bolesnika utvrđena je statistički značajna razlika u polnoj distribuciji (p = 0,011), starosti (p = 0,001), nivou AST (p = 0,013), gama globulina (p < 0,001), IgM (p = 0,007), IgG (p < 0,001), kao i uspehu terapije pegIFN-α2a + RBV. Odds ratio za nepovoljan ishod terapije u grupi A je bio 4,2 (OR = 4,200 (95% CI: 1,545-11,417)). Multivarijantnom analizom logističke regresije prediktorni faktor uspostavljanja SVR u grupi A je starost bolesnika (OR = 0,781; 95% CI: 0,603-0,959). Najčešći neželjeni efekat terapije u grupi A je bio interferonom indukovan tireoiditis (IIT) (41,9% vs. 3,3%; p < 0,001) i anemija, koja je ujedno bila i jedini razlog za redukciju doze ribavirina (29% vs. 6,7%; p = 0,027). Zaključak Oboleli od HHC i AITD kao ektrahepatičnom manifestacijom postižu slabiji virusološki odgovor na terapiju pegIFN-α2a + RBV, koja je i neizostavno praćena manifestacijom neželjenih efekata, na prvom mestu IIT i anemijom.
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O članku

jezik rada: engleski
vrsta rada: originalan članak
DOI: 10.2298/SARH160328007R
objavljen u SCIndeksu: 21.05.2017.

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