Annicchiarico B E, Siciliano M, Avolio A W, Grillo R L, Bombardieri G
Istituto di Patologia Medica, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Rome, Italy.
Aliment Pharmacol Ther. 2007 May 1;25(9):1039-46. doi: 10.1111/j.1365-2036.2007.03295.x.
Persistence of hepatitis C virus (HCV) in serum is assured after any course of antiviral therapy that failed to obtain a sustained virological response.
To evaluate the long-term effect on serum HCV-RNA of a course of pegylated-interferon and ribavirin therapy that was unable to obtain sustained response.
Serum HCV-RNA was determined at monthly intervals in 68 non-responders, breakthroughs or relapsers and in 52 naïve controls enrolled in a five-year study.
Five genotype 2 or 3 patients (one non-responder, three breakthroughs, one relapser) cleared HCV-RNA after the end of therapy or relapse, and remained negative until the end of follow-up. HCV-RNA clearance rate in genotype 2 and 3 non-responders, breakthroughs or relapsers was higher than in controls with the same genotypes (22.7% vs. 0%; log-rank 9.62; P < 0.002). HCV-RNA at the end of treatment or at relapse was <10(5) IU/mL in the five subjects who cleared the virus and <10(4) IU/mL in four of them. None of genotype 1 or 4 subjects cleared HCV-RNA during follow-up.
Late resolution of HCV infection is possible in genotype 2 or 3 patients with low viral load at the end of therapy or at relapse. In these subjects, HCV-RNA monitoring is advisable during the first year after therapy.
在任何未能获得持续病毒学应答的抗病毒治疗疗程后，丙型肝炎病毒（HCV）在血清中持续存在。
评估聚乙二醇干扰素和利巴韦林治疗疗程未能获得持续应答对血清HCV-RNA的长期影响。
在一项为期五年的研究中，对68例无应答者、突破病例或复发者以及52例初治对照者每月测定血清HCV-RNA。
5例基因2型或3型患者（1例无应答者、3例突破病例、1例复发者）在治疗结束或复发后清除了HCV-RNA，并在随访结束时保持阴性。基因2型和3型无应答者、突破病例或复发者的HCV-RNA清除率高于相同基因型的对照者（22.7%对0%；对数秩检验9.62；P<0.002）。在清除病毒的5例患者中，治疗结束或复发时的HCV-RNA<10⁵IU/mL，其中4例<10⁴IU/mL。在随访期间，基因1型或4型患者均未清除HCV-RNA。
治疗结束或复发时病毒载量低的基因2型或3型患者，HCV感染有可能晚期清除。对于这些患者，建议在治疗后的第一年进行HCV-RNA监测。
