Hasan Fuad, Al-Khaldi Jameela, Asker Haifa, Al-Ajmi Misfer, Owayed Salem, Varghese Rosh, Siddique Iqbal, Al-Nakib Basil
Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait.
Antivir Ther. 2004 Aug;9(4):499-503.
A significant proportion of hepatitis C patients treated with unmodified interferon plus ribavirin fail to respond. The optimal therapy for these patients has not been established yet. The objective of this study was to assess the efficacy and safety of peginterferon plus ribavirin with or without amantidine in such patients.
In this open-label, prospective controlled trial, a total of 63 patients were randomly divided into groups A and B with a ratio of 1:2. Group A (21 patients) received weekly peginterferon alpha-2b, 1.5 microg/kg concomitantly with ribavirin 1000-1200mg per day. Group B (42 patients) received peginterferon and ribavirin as in group A, plus amantadine [corrected] 200 mg per day.
At the completion of treatment, serum levels of hepatitis C virus RNA were undetectable in 14% and 12% of patients in groups A and B, respectively (P=NS). Hepatitis C virus RNA remained undetectable 24 weeks after the end of treatment in one patient (5%) in group A and three patients (7%) in group B (P=NS). Sustained viral clearance was associated with sustained normalization of serum alanine aminotransferase level. Both drug regimens had similar side effect profiles.
Peginterferon plus ribavirin therapy with or without amantadine [corrected] is associated with a low sustained virological response in patients who failed interferon and ribavirin combination therapy.
相当一部分接受未修饰干扰素加利巴韦林治疗的丙型肝炎患者无反应。这些患者的最佳治疗方案尚未确定。本研究的目的是评估聚乙二醇干扰素加利巴韦林联合或不联合金刚烷胺在此类患者中的疗效和安全性。
在这项开放标签的前瞻性对照试验中,共63例患者以1:2的比例随机分为A组和B组。A组(21例患者)每周接受聚乙二醇干扰素α-2b 1.5μg/kg,同时每日接受利巴韦林1000 - 1200mg。B组(42例患者)接受与A组相同的聚乙二醇干扰素和利巴韦林治疗,另加每日200mg金刚烷胺。
治疗结束时,A组和B组分别有14%和12%的患者血清丙型肝炎病毒RNA检测不到(P = 无显著性差异)。治疗结束24周后,A组有1例患者(5%)、B组有3例患者(7%)血清丙型肝炎病毒RNA仍检测不到(P = 无显著性差异)。持续病毒清除与血清丙氨酸氨基转移酶水平持续正常化相关。两种治疗方案的副作用谱相似。
对于干扰素和利巴韦林联合治疗失败的患者,聚乙二醇干扰素加利巴韦林治疗联合或不联合金刚烷胺的持续病毒学应答率均较低。