Tomimatsu Masahiko, Aizawa Yoshio, Chuganji Yoshimichi, Ishizuka Hideo, Fujita Yoshiyuki, Aizawa Ryouichi, Abe Hiroshi, Matsuda Takako, Itou Yumi, Nakanishi Hiroyuki, Ushiyama Hisashi, Higuchi Teruhisa, Fujimoto Tomoko, Endou Hitoshi, Iga Daijiro, Ohta Kazuki, Kuroda Hiroyuki
Department of Medicine, Tokyo Women's Medical University, Daini Hospital, Tokyo, Japan.
J Gastroenterol Hepatol. 2006 Jul;21(7):1177-83. doi: 10.1111/j.1440-1746.2006.04311.x.
In chronic hepatitis C patients with genotype 1b and a high viral load, the sustained virological response (SVR) rate remained as low as 2-3% with conventional interferon (IFN) monotherapy, but improved to more than 20% with IFN alpha-2b plus ribavirin combination therapy. This study examined the therapeutic effects and predictors of this combination therapy.
Subjects were 105 patients with chronic hepatitis C (73 males, 32 females) with a median age of 53 years (range 19-70 years). Seventy-two patients had genotype lb and 33 patients had genotype 2 (2a or 2b). Six million units (MU) or 10 MU of IFN alpha-2b was administered by intramuscular injection six times a week for the first 2 weeks, and the same amount of IFN was administered three times a week for the following 22 weeks. During the IFN administration period, 600-800 mg of oral ribavirin was administered daily. Patients who were hepatitis C virus (HCV)-RNA negative 24 weeks after the completion of administration were defined as SVR.
The overall SVR rate was 39%; 22.2% for the genotype 1b group and 75.8% for the genotype 2 group, and the difference between the groups was significant (P < 0.0001). Multivariate logistic regression analysis indicated that the factors that contributed to SVR include genotype 2, age (younger than 53 years), and an increase in Th2 measured by flow cytometry before and 4 weeks after start of treatment.
The overall SVR rate of IFN alpha-2b plus ribavirin combination therapy for 24 weeks was 39%, and contributing factors for SVR rate include genotype 2, age younger than 53 years and elevated Th2.
在基因1b型且病毒载量高的慢性丙型肝炎患者中，传统干扰素（IFN）单药治疗的持续病毒学应答（SVR）率低至2%-3%，但干扰素α-2b联合利巴韦林治疗可使其提高至20%以上。本研究探讨了该联合治疗的疗效及预测因素。
研究对象为105例慢性丙型肝炎患者（男性73例，女性32例），中位年龄53岁（19-70岁）。其中72例为基因1b型，33例为基因2型（2a或2b）。前2周，每周6次肌肉注射600万单位（MU）或10MU的干扰素α-2b，随后22周，每周3次注射相同剂量的干扰素。在干扰素治疗期间，每日口服600-800mg利巴韦林。治疗结束24周后丙型肝炎病毒（HCV）-RNA阴性的患者被定义为获得SVR。
总体SVR率为39%；基因1b型组为22.2%，基因2型组为75.8%，两组差异有统计学意义（P<0.0001）。多因素logistic回归分析表明，与SVR相关的因素包括基因2型、年龄（小于53岁）以及治疗开始前和开始后4周通过流式细胞术检测到的Th2增加。
干扰素α-2b联合利巴韦林治疗24周的总体SVR率为39%，与SVR率相关的因素包括基因2型、年龄小于53岁和Th2升高。
