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[干扰素α与利巴韦林联合治疗丙型肝炎病毒和人类免疫缺陷病毒合并感染]

[Interferon-alpha and ribavirin combination therapy for co-infection of hepatitis C virus and human immunodeficiency virus].

作者信息

Zheng Yu-huang, He Yan, Yang Xu, Gong Guo-zhong, Zhou Hua-ying, Zhang Chun-ying, Zhou Wen, Huang Li, Ding Pei-pei, Li Hui

机构信息

AIDS Research Laboratory, Second Xiangya Hospital, Central South University, Changsha 410011, China.

出版信息

Zhonghua Gan Zang Bing Za Zhi. 2005 Oct;13(10):741-4.

Abstract

OBJECTIVE

To evaluate the clinical effect and side-effect of interferon-alpha (IFN-a) and ribavirin (RBV) combination therapy for Chinese patients with co-infection of hepatitis C virus (HCV) and human immunodeficiency virus (HIV), and to compare them with only HIV infection patients.

METHODS

10 patients with HCV-HIV and 17 patients with only HCV infection received 5 million units of IFNalpha-2b every other day intramuscularly, and 300 mg RBV orally three times a day. Dynamic observations were done for HCV RNA and HIV RNA loads, CD4+ and CD8+ T lymphocyte counts, liver function and blood cell measures, and the side-effects of the medicines.

RESULTS

After 12 weeks and 24 weeks of IFNalpha and RBV combination therapy, mean HCV RNA levels reduced 1.14 log (t = 3.843, P < 0.01) and 2.08 log (t =6.564, P < 0.01) from the baseline at week 0 in the HCV-HIV co-infection group, and reduced 1.48 log (t = 6.438, P less than 0.01) and 2.33 log (t = 7.343, P < 0.01) in the HCV infection group. Meanwhile, the HIV RNA levels decreased 1.22 log (t = 3.662, P < 0.01) and 1.73 log (t = 6.119, P < 0.01) from the base line. However, there were no obvious different changes among T lymphocyte counts of HCV-HIV and HCV patients at week 0, week 12 and week 24. All 27 patients showed satisfactory biochemical response to therapy. There were some mild or moderate influenza-like symptoms, intestinal discomfort and decreased blood cell counts in the early stages of the treatments. No neuropsychic and auto-immune disorders were found.

CONCLUSIONS

IFNalpha-2b and RBV combination therapy showed similar anti-HCV effects during the 24 week treatment for HCV-HIV and HCV infected patients, and some anti-HIV effect was also observed. No obvious different biochemical responses and side-effects were found between the above two groups.

摘要

目的

评估干扰素-α(IFN-α)联合利巴韦林(RBV)治疗丙型肝炎病毒(HCV)和人类免疫缺陷病毒(HIV)合并感染的中国患者的临床疗效和副作用,并与仅感染HIV的患者进行比较。

方法

10例HCV-HIV合并感染患者和17例仅感染HCV的患者,隔日肌肉注射500万单位的IFNα-2b,每日口服300mg RBV,分三次服用。对HCV RNA和HIV RNA载量、CD4+和CD8+ T淋巴细胞计数、肝功能和血细胞指标以及药物副作用进行动态观察。

结果

在HCV-HIV合并感染组,IFNα和RBV联合治疗12周和24周后,平均HCV RNA水平较0周基线分别降低1.14对数(t = 3.843,P < 0.01)和2.08对数(t = 6.564,P < 0.01);在HCV感染组,分别降低1.48对数(t = 6.438,P < 0.01)和2.33对数(t = 7.343,P < 0.01)。同时,HIV RNA水平较基线分别降低1.22对数(t = 3.662,P < 0.01)和1.73对数(t = 6.119,P < 0.01)。然而,在0周、12周和24周时,HCV-HIV合并感染患者和HCV患者的T淋巴细胞计数没有明显差异。所有27例患者对治疗均表现出满意的生化反应。治疗早期出现一些轻度或中度的流感样症状、肠道不适和血细胞计数下降,但未发现神经精神和自身免疫性疾病。

结论

在对HCV-HIV合并感染患者和HCV感染患者进行的24周治疗中,IFNα-2b联合RBV治疗显示出相似的抗HCV效果,同时也观察到一定的抗HIV效果。上述两组之间未发现明显不同的生化反应和副作用。

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