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Objective To investigate the correlation between the changes in routine blood test results and antiviral effect in patients with refractory chronic hepatitis C receiving standard treatment. Methods A total of 63 previously untreated patients with refractory chronic hepatitis C who visited Beijing YouAn Hospital, Capital Medical University, from September 2011 to December 2012 were enrolled. The patients were treated with pegylated interferon - α -2a 180 μg/week and ribavirin (RBV) for 48 weeks. HCV RNA measurement and routine blood tests were performed at baseline and weeks 4, 12, and 24 of treatment to analyze the correlation between routine blood test results and antiviral effect. According to the status of sustained virologic response (SVR) , the patients were divided into SVR group and nSVR group. The t - test was used for comparison of continuous data between groups, the chi - square test was used for comparison of categorical data between groups, and a simple linear correlation analysis was performed. Results Of the 63 patients, three were lost to follow - up, and the other 60 patients completed the antiviral therapy and 24 - week follow - up; among the 60 patients, 46 achieved SVR, resulting in an SVR rate of 76.7%. Compared with the nSVR group, the SVR group showed lower absolute lymphocyte count ( LYPH) , white blood cell count (WBC) , and absolute neutrophil count (NUET) , and the three indicators were significantly different between the two groups at 12 weeks (t = 3. 398, 2. 766, and 2. 037, all P < 0. 05) ; WBC and NUET still showed significant differences between the two groups at 24 weeks (t =2.559 and 2. 151, both P <0.05). In addition, at week 4 of treatment, the SVR group showed significantly greater reductions in these three indicators from baseline compared with the nSVR group, LYPH showed significant different between the two groups (t = 2. 26, P = 0.03). At weeks 4 and 12 of treatment, LYPH, WBC, and NEUT were positively correlated with the reduction in HCV RNA (r =0.36, 0. 45 , 0. 37 , 0. 47 , 0.61, and 0. 33 , all P < 0. 05 ) . Conclusion The reductions in LYPH, WBC, and NEUT can be used as predictive indicators for antiviral effect in patients with refractory chronic hepatitis C. [ABSTRACT FROM AUTHOR]

Objective To investigate the chages in NK cells ad regulatory T (Treg) cells among patients with refractory chronic hepatitis C (CHC) during antiviral therapy ad to analyze antiviral effect - related immunological factors. Methods A total of 41 patients with refractory CHC (30 treatment - naive patients and 11 treatment - unresponsive patients) and 11 healthy controls ( HC) were enrolled in this prospective open cohort study. Naive patients received pegylated interferon a - 2a ( Peg - IFN- a - 2a) 180 jxg/week and ribavirin ( RBV) 10. 6 - 15 mg/kg/day for 48 weeks , while unresponsive patients received Peg - IFN - a - 2a 180 jxg/"week and RBV 15 mg/kg/day for 72 weeks. Blood cells and serum were dynamic^ly collected to measure HCV RNA , liver function , NK cells and Treg cells and to an^yze curative effect - related immunological factors. Continuous variables were analyzed by t - test or rank sumtest , and discrete variables were analyzed by chi - square test. Results All patients finished antiviral treatment and 24 - week follow - up survey. Seventeen naive patients (56. 7% ) and 3 unrespons- ive patients (27.2%) achieved a sustained virologic response (SVR). The 8 unresponsive patients without SVR were named response - free patients(RFP). At baseline，the percentage of NKcells in patients was lower than that in the HC group，while the percentage of Treg cells in patients was higher than that in the HC group. During antiviral therapy，in naive patients with SVR，the percentage of NK cells increased at week 24 of treatment，as compared withthe baseline and week 4，and the percentage of Treg cells decreased at week 24，as compared withthe baseline and week 4; In naive patients without SVR，the percentage of Treg cells increased at week 24，as compared with the baseline and week 4 ； no significant change in the percentage of NK cells or Treg cells was observed in unresponsive patients without SVR.Conclusion Decrease in NK cells and increase in Treg cells are related to chronic HCV infection. Dynamic changes in NK cells and Treg cells can predict the efficacy of antiviral therapy： the increase in NK cells and decrease in Treg cells, which are indicative of upregulation immune function and downregulation of immunosuppression, can be used for predicting SVR. [ABSTRACT FROM AUTHOR]