Kowala-Piaskowska A, Słuzewski W, Figlerowicz M, Mozer-Lisewska I
Dept. Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences, Szpitalna 27/33, 60-572 Poznan, Poland.
Infection. 2007 Jun;35(3):175-9. doi: 10.1007/s15010-007-6072-5.
Infection with hepatitis C virus (HCV) is widespread worldwide. It is estimated that this problem affects approximately 3% of global population. By introducing weekly doses of pegylated interferon (IFN) alfa in combination with ribavirin, given daily, to chronic hepatitis C (CHC) treatment one can achieve a full inhibition of HCV replication in 54-56% of adult patients. The aim of this study was to examine the relationship between prognostic factors and early virological response (EVR) after combination treatment with peginterferon alfa- 2a or alfa-2b and ribavirin in children with CHC.
Twenty-three children with chronic HCV were treated with a combination of peginterferon alfa-2a or alfa-2b once a week and ribavirin twice a day. Assessment included age at the time of infection, the length of infection, HCV genotype, viral load in serum and HCV RNA level in peripheral blood mononuclear cells (PBMCs), alanine aminotransferase (ALT) activity and adherence to therapy. The efficacy endpoint was EVR defined as undetectable HCV RNA in serum or >2 log10 decrease in HCV RNA compared with baseline values.
An EVR was achieved in 15 out of 23 patients (65.3%) after 12 weeks of therapy.
Lower HCV RNA viral load have positive influence on EVR. HCV RNA presence in PBMCs and lower ALT activity do not influence the achievement of EVR. Oncologic history does not bear any influence on EVR. Adherence to the therapy has an unclear influence on the achievement of EVR in children with CHC.
丙型肝炎病毒（HCV）感染在全球广泛存在。据估计，这一问题影响着全球约3%的人口。通过在慢性丙型肝炎（CHC）治疗中引入每周一次的聚乙二醇化干扰素（IFN）α联合每日服用的利巴韦林，可使54 - 56%的成年患者实现HCV复制的完全抑制。本研究的目的是探讨聚乙二醇化干扰素α - 2a或α - 2b与利巴韦林联合治疗CHC患儿后，预后因素与早期病毒学应答（EVR）之间的关系。
23例慢性HCV感染患儿接受聚乙二醇化干扰素α - 2a或α - 2b每周一次联合利巴韦林每日两次的治疗。评估内容包括感染时的年龄、感染时长、HCV基因型、血清病毒载量、外周血单个核细胞（PBMCs）中的HCV RNA水平、丙氨酸氨基转移酶（ALT）活性以及治疗依从性。疗效终点为EVR，定义为血清中HCV RNA检测不到或与基线值相比HCV RNA下降>2 log10。
治疗12周后，23例患者中有15例（65.3%）实现了EVR。
较低的HCV RNA病毒载量对EVR有积极影响。PBMCs中存在HCV RNA以及较低的ALT活性不影响EVR的实现。肿瘤病史对EVR无任何影响。治疗依从性对CHC患儿EVR的实现影响不明确。
