血友病患者慢性丙型肝炎治疗的疗效与安全性

Efficacy and safety of chronic hepatitis C treatment in hemophilic patients.

作者信息

Husa P, Roznovsky L, Smejkal P, Husova L, Penka M, Dite P

机构信息

Department of Infectious Diseases, University Hospital Brno, Czech Republic.

出版信息

Hepatogastroenterology. 2005 Sep-Oct;52(65):1541-4.

PMID:16201114

Abstract

BACKGROUND/AIMS: Chronic hepatitis C infection is very common among hemophiliacs in the developed World.

METHODOLOGY

Retrospective evaluation of the treatment results in hemophiliacs with chronic hepatitis C, all infected with genotype 1b. Twelve patients were treated with interferon-alpha monotherapy, 21 patients with interferon-alpha and ribavirin, and 3 patients with pegylated interferon and ribavirin, all for 48 weeks.

RESULTS

Sustained virologic response (defined as an undetectable serum HCV RNA level 24 weeks after treatment was completed) was not achieved in any of 12 patients treated with interferon-alpha alone. Combination therapy with interferon-alpha and ribavirin was associated with better results: 4/10 (40%) patients still untreated with interferon-alpha, 2/4 (50%) relapsers, and 2/7 (29%) non-responders to previous interferon-alpha monotherapy achieved sustained virologic responses. Combination therapy with pegylated interferon and ribavirin has been used in 3 patients. Sustained response was achieved in one patient who had relapsed after treatment with interferon-alpha and ribavirin and in 1 of 2 non-responders to this combination therapy. There were no serious adverse events and it was not necessary to reduce dosages or even cease therapy prematurely.

CONCLUSIONS

The efficacy and tolerability of antiviral treatment in hemophiliacs did not differ from other patients with chronic hepatitis C.

摘要

背景/目的：在发达国家，丙型肝炎慢性感染在血友病患者中非常普遍。

方法

对所有感染1b型基因型的丙型肝炎慢性感染血友病患者的治疗结果进行回顾性评估。12例患者接受α干扰素单一疗法治疗，21例患者接受α干扰素与利巴韦林联合治疗，3例患者接受聚乙二醇化干扰素与利巴韦林联合治疗，疗程均为48周。

结果

接受单一α干扰素治疗的12例患者中，无一例实现持续病毒学应答（定义为治疗结束后24周血清HCV RNA水平检测不到）。α干扰素与利巴韦林联合治疗效果更佳：在之前未接受过α干扰素治疗的10例患者中有4例（40%）、复发患者中有2例（50%）、之前单一α干扰素治疗无应答患者中有2例（29%）实现了持续病毒学应答。3例患者接受了聚乙二醇化干扰素与利巴韦林联合治疗。1例在接受α干扰素与利巴韦林治疗后复发的患者以及2例该联合治疗无应答患者中的1例实现了持续应答。未发生严重不良事件，无需减少剂量甚至提前终止治疗。