聚乙二醇干扰素α-2b与利巴韦林联合治疗对丙型肝炎病毒（HCV）感染或HCV与人类免疫缺陷病毒（HIV）合并感染患者肝脏组织的影响。

Impact of peginterferon alpha-2b and ribavirin treatment on liver tissue in patients with HCV or HCV-HIV co-infection.

作者信息

Sarmento-Castro Rui, Horta Ana, Vasconcelos Olga, Coelho Helena, Mendez Josefina, Tavares Ana Paula, Seabra João, Duarte Manuela, Chaves Leonor, Fortes Olga, Recalde Cristina, Ventura Angela, Pires Nuno, Pinho Luciana, Dias Nancy, Carneiro Fátima

机构信息

Infectious Diseases Department, Hospital de Joaquim Urbano, Rua Câmara Pestana 348, 4369-004 Porto, Portugal.

出版信息

J Infect. 2007 Jun;54(6):609-16. doi: 10.1016/j.jinf.2006.11.010. Epub 2006 Dec 27.

DOI:10.1016/j.jinf.2006.11.010

PMID:17194480

Abstract

OBJECTIVE

To evaluate the effect of treatment with peginterferon alpha-2b and ribavirin on liver histology in patients with chronic hepatitis C (CHC) with or without HIV infection.

METHODS

Patients received peginterferon alpha-2b (1.5 micro/kg/week during the first 4 weeks; 1.0 micro/kg/week thereafter) plus ribavirin (800-1200 mg/day, adjusted for weight) for 24 (genotypes 2/3) or 48 weeks (genotypes 1/4). Paired liver biopsy specimens were obtained at baseline and at the end of follow-up.

RESULTS

108 paired biopsy specimens were available: 67 from HCV-monoinfected and 41 from co-infected patients. At the end of follow-up, necroinflammatory activity (NIA) was significantly reduced (P<0.001), and fibrosis scores improved by > or = 1 point (Ishak et al criteria) in 65.7% of HCV-monoinfected patients. In co-infected patients, NIA was significantly reduced (P<0.001), and fibrosis scores improved by > or = 1 point in 42.5% of cases. In both groups, results were better for patients who attained sustained virological response (SVR). HCV RNA was undetectable in the second biopsy specimens of all patients who attained SVR.

CONCLUSION

Liver fibrosis is reduced significantly after a course of therapy in patients with chronic hepatitis C. Reduction of fibrosis is more significant in patients who are monoinfected with HCV and in those who attained SVR.

摘要

目的

评估聚乙二醇干扰素α-2b联合利巴韦林治疗对合并或未合并人类免疫缺陷病毒（HIV）感染的慢性丙型肝炎（CHC）患者肝脏组织学的影响。

方法

患者接受聚乙二醇干扰素α-2b（前4周1.5μg/kg/周；之后1.0μg/kg/周）联合利巴韦林（800 - 1200mg/天，根据体重调整）治疗24周（基因2/3型）或48周（基因1/4型）。在基线和随访结束时获取配对的肝脏活检标本。

结果

共获得108对活检标本：67对来自单纯丙型肝炎病毒（HCV）感染患者，41对来自合并感染患者。随访结束时，单纯HCV感染患者的坏死性炎症活动度（NIA）显著降低（P<0.001），65.7%的患者纤维化评分改善≥1分（依沙克等标准）。在合并感染患者中，NIA显著降低（P<0.001），42.5%的患者纤维化评分改善≥1分。在两组中，获得持续病毒学应答（SVR）的患者结果更好。所有获得SVR的患者第二次活检标本中均未检测到HCV RNA。