Formann E, Steindl-Munda P, Hofer H, Jessner W, Bergholz U, Gurguta C, Ferenci P
Department of Internal Medicine IV, Gastroenterology and Hepatology, Medical University of Vienna, Austria.
Aliment Pharmacol Ther. 2006 Feb 15;23(4):507-11. doi: 10.1111/j.1365-2036.2006.02785.x.
Combination anti-viral therapy achieves a sustained virological response (defined as HCV-RNA negativity 6 months after the end of therapy) of 56% of patients with chronic hepatitis C. Little is known about long-term durability of HCV-RNA negativity in patient treated with pegylated interferon.
To evaluate the durability of virologic response in patients with sustained virological response to anti-viral therapy treated at our centre.
A total of 187 sustained virological responses (50% genotype 1, 42% genotype 2 or 3 and 8% genotype 4; 20% with cirrhosis) with a follow-up of >12 months post-therapy were studied. Twelve patients received monotherapy with interferon-alpha2a or -2b. One hundred and seventy-five received combination therapy with ribavirin and standard interferon-alpha (n = 73) or pegylated interferon-alpha2a or 2b (n = 102). Qualitative serum HCV-RNA was tested by COBAS AMPLICOR HCV test, v2.0.
Median follow-up time was 29 months (range 12-172). Recurrence of HCV infection was not observed in any of the 187 sustained virological responders. Alanine aminotransferase values were normal in 90% and two patients showed minimal elevation of alpha-fetoprotein levels.
No recurrence of HCV infection was seen in any patient. Thus, long-term prognosis in chronic hepatitis C patients with a sustained virological response to therapy with pegylated interferon +/- ribavirin is promising, but long-term studies need to continue.
联合抗病毒治疗使56%的慢性丙型肝炎患者获得持续病毒学应答（定义为治疗结束后6个月丙型肝炎病毒核糖核酸呈阴性）。关于接受聚乙二醇化干扰素治疗的患者丙型肝炎病毒核糖核酸阴性的长期持续性知之甚少。
评估在本中心接受抗病毒治疗获得持续病毒学应答的患者的病毒学应答持续性。
共研究了187例获得持续病毒学应答的患者（50%为基因1型，42%为基因2或3型，8%为基因4型；20%有肝硬化），治疗后随访时间>12个月。12例患者接受了干扰素-α2a或 -2b单药治疗。175例患者接受了利巴韦林与标准干扰素-α（n = 73）或聚乙二醇化干扰素-α2a或2b（n = 102）的联合治疗。采用COBAS AMPLICOR HCV检测试剂盒v2.0检测血清丙型肝炎病毒核糖核酸定性。
中位随访时间为29个月（范围12 - 172个月）。187例获得持续病毒学应答的患者中均未观察到丙型肝炎病毒感染复发。90%的患者丙氨酸氨基转移酶值正常，2例患者甲胎蛋白水平轻度升高。
所有患者均未出现丙型肝炎病毒感染复发。因此，对聚乙二醇化干扰素±利巴韦林治疗获得持续病毒学应答的慢性丙型肝炎患者，其长期预后良好，但仍需继续进行长期研究。
