da Silva Luiz Caetano, Bassit Leda, Ono-Nita Suzane Kioko, Pinho João Renato Rebello, Nishiya Ana, Madruga Carmen Lucia, Carrilho Flair José
Institute of Tropical Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil.
J Gastroenterol. 2002;37(9):732-6. doi: 10.1007/s005350200119.
The aim of this study was to evaluate an alternative treatment (consensus interferon plus ribavirin) for chronic hepatitis C patients resistant to combined therapy.
Fourteen patients previously resistant to interferon alpha plus ribavirin were consecutively assigned to receive 15 microg of consensus interferon plus ribavirin (1000 mg) daily for 4 weeks, and 9-15 microg every other day plus daily ribavirin for the following 44 weeks. Alanine aminotransferase and hepatitis C virus (HCV) RNA (Amplicor Monitor; Roche) levels were monitored during therapy and for 24 weeks after its completion.
A rapid and marked decrease of HCV RNA viremia of more than 2 logs was observed in 10 (71%) of 14 patients at week 2 of treatment. At the end of therapy, 10 (71%) of 14 patients had undetectable HCV RNA. The end-of-treatment response rates were 6 of 9 (67%) patients for genotype 1 and 4 of 5 (80%) for other genotypes. Sustained response was observed in 4 (36%) of 11 patients who completed 24 weeks of follow-up.
A marked and rapid decrease of viral load was observed during therapy with high doses of consensus interferon plus ribavirin in patients previously resistant to combined therapy, even in those infected with genotype 1. Of 11 patients who completed the post-treatment follow-up, 36% presented a sustained response.
本研究旨在评估一种针对联合治疗耐药的慢性丙型肝炎患者的替代治疗方案（共识干扰素联合利巴韦林）。
连续将14例先前对干扰素α联合利巴韦林耐药的患者分配接受每日15微克共识干扰素联合利巴韦林（1000毫克）治疗4周，随后44周每隔一天接受9 - 15微克共识干扰素联合每日利巴韦林治疗。在治疗期间及治疗结束后24周监测丙氨酸氨基转移酶和丙型肝炎病毒（HCV）RNA（Amplicor Monitor；罗氏公司）水平。
治疗第2周时，14例患者中有10例（71%）观察到HCV RNA病毒血症迅速且显著下降超过2个对数级。治疗结束时，14例患者中有10例（71%）HCV RNA检测不到。治疗结束时的反应率，1型基因型患者为9例中的6例（67%），其他基因型患者为5例中的4例（80%）。完成24周随访的11例患者中有4例（36%）观察到持续反应。
在先前对联合治疗耐药的患者中，即使是感染1型基因型的患者，在高剂量共识干扰素联合利巴韦林治疗期间也观察到病毒载量迅速且显著下降。在完成治疗后随访的11例患者中，36%呈现持续反应。
