α-干扰素2b与利巴韦林联合治疗HIV感染患者严重慢性丙型肝炎的长期疗效

Long-term efficacy of combination therapy with interferon-alpha 2b and ribavirin for severe chronic hepatitis C in HIV-infected patients.

作者信息

Landau A, Batisse D, Piketty C, Duong Van Huyen J P, Bloch F, Belec L, Bruneval P, Weiss L, Jian R, Kazatchkine M D

机构信息

Department of Hepatology and Gastroenterology, Hôpital Européen Georges Pompidou and Université Pierre et Marie Curie, Paris, France.

出版信息

AIDS. 2001 Nov 9;15(16):2149-55. doi: 10.1097/00002030-200111090-00010.

DOI:10.1097/00002030-200111090-00010

PMID:11684934

Abstract

BACKGROUND

We have assessed the long-term efficacy and safety of a combination therapy of interferon alpha-2b (IFN) and ribavirin (RBV) for the treatment of severe chronic hepatitis C in co-infected HIV-seropositive patients in an open prospective study.

METHODS

Fifty-one patients were treated for 12 months. Mean baseline CD4 cell count, alanine aminotransferase and aspartate aminotransferase were 412 +/- 232 x 106/l, 113 +/- 75 IU/l and 111 +/- 84 IU/l respectively. The mean Knodell score was 11.5 +/- 2.1 with 28 patients (55%) exhibiting histological evidence of active cirrhosis.

RESULTS

Fifteen (29%) patients discontinued the treatment prematurely because of adverse events. An end of treatment response (ETR) as defined by the lack of detectable hepatitis C virus (HCV) RNA in plasma at the end of treatment was achieved in 15 patients (29%). A sustained virological response (SVR), defined by the lack of detectable HCV RNA in plasma 6 months after completion of combination therapy, was achieved in 11 patients (21%). The HCV genotype 3a was associated with ETR and SVR (P = 0.002 and P = 0.003, respectively). HCV viraemia at baseline was lower in patients who achieved SVR and ETR than in those who did not (6.7 +/- 7.8 versus 24 +/- 26.7 x 10(6) genome equivalents/ml, P = 0.03 and 14.3 +/- 28.7 versus 22.5 +/- 23, P = 0.05, respectively).

CONCLUSION

Our results indicate that combination therapy with IFN and RBV is effective in approximately 20% of co-infected patients with severe liver disease.

摘要

背景

在一项开放性前瞻性研究中，我们评估了干扰素α-2b（IFN）和利巴韦林（RBV）联合治疗对合并感染HIV的血清学阳性患者的严重慢性丙型肝炎的长期疗效和安全性。

方法

51例患者接受了12个月的治疗。平均基线CD4细胞计数、丙氨酸转氨酶和天冬氨酸转氨酶分别为412±232×10⁶/L、113±75 IU/L和ll1±84 IU/L。平均Knodell评分为11.5±2.1，28例患者（55%）有活动性肝硬化的组织学证据。

结果

15例（29%）患者因不良事件提前终止治疗。15例患者（29%）达到治疗结束反应（ETR），定义为治疗结束时血浆中检测不到丙型肝炎病毒（HCV）RNA。11例患者（21%）达到持续病毒学反应（SVR），定义为联合治疗完成后6个月血浆中检测不到HCV RNA。HCV基因3a型与ETR和SVR相关（分别为P = 0.002和P = 0.003）。达到SVR和ETR的患者基线时的HCV病毒血症低于未达到的患者（分别为6.7±7.8对24±26.7×10⁶基因组当量/ml，P = 0.03；14.3±28.7对22.5±23，P = 0.05）。