Krawitt Edward L, Ashikaga Takamaru, Gordon Stuart R, Ferrentino Nicholas, Ray Mary Ann, Lidofsky Steven D
Department of Medicine, University of Vermont, Burlington, VT, USA.
J Hepatol. 2005 Aug;43(2):243-9. doi: 10.1016/j.jhep.2005.03.015.
BACKGROUND/AIMS: Treatment regimens with pegylated interferons have yielded improved response rates, compared with conventional interferon-based regimens, for chronic hepatitis C. However, little is known about the utility of such regimens for individuals who failed to respond to prior conventional interferon-based treatment.
182 patients who had previously failed to eliminate circulating hepatitis C virus 24 weeks after completion of a multi-week course of either interferon monotherapy or interferon in combination with ribavirin were treated with peginterferon alfa-2b weekly and ribavirin daily for 48 weeks.
The sustained viral response, was 20% (23/116) in previous non-responders and 55% (36/66) in previous relapsers (P<0.001). In previous non-responders, the sustained viral response in those with viral genotype 1 was 17% (19/109) compared to 57% (4/7) in those with genotypes 2 and 3 (P=0.03). In previous relapsers, the sustained viral response in those with viral genotype 1 was 53% (26/49) compared to 59% (10/17) with genotypes 2 and 3 (P=0.78).
The response to pegylated interferon and ribavirin in previous non-responders with genotypes 2 and 3 and in prior relapsers with chronic hepatitis C is comparable to overall sustained viral response rates seen in previously untreated patients.
背景/目的：与基于传统干扰素的治疗方案相比，聚乙二醇化干扰素治疗方案可提高慢性丙型肝炎的应答率。然而，对于先前基于传统干扰素治疗无应答的个体，此类方案的效用知之甚少。
182例患者在完成干扰素单药治疗或干扰素联合利巴韦林的多周疗程后24周未能清除循环中的丙型肝炎病毒，接受聚乙二醇化干扰素α-2b每周一次和利巴韦林每日一次治疗48周。
先前无应答者的持续病毒学应答率为20%（23/116），先前复发者为55%（36/66）（P<0.001）。在先前无应答者中，病毒基因型1患者的持续病毒学应答率为17%（19/109），而基因型2和3患者为57%（4/7）（P=0.03）。在先前复发者中，病毒基因型1患者的持续病毒学应答率为53%（26/49），基因型2和3患者为59%（10/17）（P=0.78）。
先前基因型2和3的无应答者以及先前复发的慢性丙型肝炎患者对聚乙二醇化干扰素和利巴韦林的应答与先前未治疗患者的总体持续病毒学应答率相当。
