聚乙二醇干扰素α-2b（12 kDa）单药治疗接受血液透析的慢性丙型肝炎感染患者。

Monotherapy with peginterferon alpha-2b {12 kDa} for chronic hepatitis C infection in patients undergoing haemodialysis.

作者信息

Amarapurkar Deepak N, Patel Nikhil D, Kirpalani Ashok L

机构信息

Department of Gastroenterology, Bombay Hospital & Medical Research Centre, Mumbai, India.

出版信息

Trop Gastroenterol. 2007 Jan-Mar;28(1):16-8.

PMID:17896604

Abstract

BACKGROUND

A combination of Peginterferon and Ribavirin is the standard treatment for patients with chronic hepatitis C viral infection (HCV). Ribavirin is contraindicated in patients with chronic renal failure (CRF). Conventional Interferon monotherapy is effective in around 30% of such patients. There is scanty data on the use of Peginterferon monotherapy in them.

METHODS

We describe our preliminary experience of monotherapy with Peginterferon alpha- 2b {12 kDa} (Peg-IFN) for HCV patients undergoing haemodialysis for CRF. They were treated with Peg-IFN 1 microg/kg body weight subcutaneously once a week for 24 weeks. In all patients, clinical (age, sex, mode of acquiring HCV, pattern of haemodialysis) and virological (HCV RNA quantitative-PCR and genotype) profile was noted at baseline. Early virological response at 12 weeks (EVR), end-of-treatment virological response at 24 weeks (ETVR) and sustained virological response after 6 months of stopping treatment (SVR) were noted during the follow-up period.

RESULTS

The clinical and virological characteristics of patients were as follows: Of a total number of 6 patients, 5 were male and 1 was female with an age range of 35 to 62 years. The duration of haemodialysis was from between 5 and 12 months before the start of treatment and its frequency lay between 1 and 3 times a week. The mode of acquiring HCV was blood transfusion (100%). All 6 cases suffered from chronic hepatitis. The genotype distribution was genotype 3 in 3 (50%), genotype 1 in 1 (16.7%) and genotype none of 6 in 2 (33.3%) patients. All the patients (100%) completed treatment. EVR was seen in all 6 patients (100%). ETVR was seen in 5 of 6 patients (83.3%). A follow-up period of more than 1 year was available in 4 patients. 3 of these 4 patients (75%) had SVR. A virological response was maintained in all 3 (100%) patients with SVR even after 6 months of renal transplantation.

CONCLUSION

Peg-IFN monotherapy is safe and effective in patients with HCV who are on haemodialysis for CRF.

摘要

背景

聚乙二醇干扰素与利巴韦林联合使用是慢性丙型肝炎病毒感染（HCV）患者的标准治疗方法。利巴韦林在慢性肾衰竭（CRF）患者中禁用。传统干扰素单药治疗对此类患者的有效率约为30%。关于聚乙二醇干扰素单药治疗此类患者的数据较少。

方法

我们描述了使用聚乙二醇干扰素α-2b（12 kDa）（Peg-IFN）对因CRF接受血液透析的HCV患者进行单药治疗的初步经验。他们接受皮下注射Peg-IFN 1μg/kg体重，每周一次，共24周。在所有患者中，在基线时记录临床（年龄、性别、感染HCV的方式、血液透析模式）和病毒学（HCV RNA定量聚合酶链反应和基因型）特征。在随访期间记录12周时的早期病毒学应答（EVR）、24周时的治疗结束时病毒学应答（ETVR）以及停止治疗6个月后的持续病毒学应答（SVR）。

结果

患者的临床和病毒学特征如下：6例患者中，5例为男性，1例为女性，年龄范围为35至62岁。血液透析时间在治疗开始前为5至12个月，频率为每周1至3次。感染HCV的方式为输血（100%）。所有6例均患有慢性肝炎。基因型分布为3例（50%）为3型，1例（16.7%）为1型，2例（33.3%）患者6型未检出。所有患者（100%）完成治疗。6例患者（100%）均出现EVR。6例患者中有5例（83.3%）出现ETVR。4例患者有超过1年的随访期。这4例患者中有3例（75%）获得SVR。即使在肾移植6个月后，所有3例获得SVR的患者（100%）病毒学应答仍得以维持。