聚乙二醇干扰素α-2a与高效抗逆转录病毒药物疗法对艾滋病合并丙型肝炎患者的作用

[Peg-interferon alfa-2a and highly active antiretroviral drug therapy on hepatitis C patients with AIDS].

作者信息

Zhang Ren-fang, Sun Hong-qing, Huang Qin, Wang Jiang-rong, Zhang Xue-xiang, Liu Xi-nian, Lu Hong-zhou

机构信息

Department of Infectious Diseases, Shanghai Public Health Clinical Center, Public Health Clinical Center Affiliated to Fudan University, Shanghai 201508, China.

出版信息

Zhonghua Gan Zang Bing Za Zhi. 2007 Oct;15(10):734-7.

PMID:17963597

Abstract

OBJECTIVE

To evaluate the clinical effect and side-effect of peg-interferon alfa-2a (PEG-IFN alfa-2a) and highly active antiretroviral therapy (HAART) for patients infected with hepatitis C virus (HCV) and co-infected with human immunodeficiency virus (HIV).

METHODS

Twenty-two patients with HCV/HIV co-infection received highly active antiretroviral therapy initially; after their CD4 lymphocyte counts rose to over 0.20x10(9)/L, they were separated into two groups: one group with CD4 lymphocytes over 0.35x10(9)/L (high group) and one group with CD4 lymphocytes below 0.35x10(9)/L (low group). Both groups were given 180 microg of PEG-IFN alfa-2a every week intramuscularly. HCV RNA and HIV RNA loads, blood cell and CD4 lymphocyte counts, and liver functions were routinely examined.

RESULTS

After 12, 24 and 48 weeks of PEG-IFN alfa-2a therapy, mean HCV RNA loads reduced 2.0650 log10 copies/ml (t=3.8733), 2.9146 log10 copies/ml (t=7.6741) and 2.4315 log10 copies/ml (t=5.8202) from the baseline at week 0 in the 13 patients in the high group, and reduced 1.1522 log10 copies/ml (t = 2.8937), 1.4189 log10 copies/ml (t=2.4422) and 1.1167 log10 (t=1.1261) in the 8 patients of the low group. However, there was no significant difference between the early viral response rate (EVR) and the end of treatment viral response rate (ETVR) of the two groups. In the high group, the white blood cell count was lower at 24 weeks than the base line (t=2.4700), and the blood platelet count was lower both at 24 and 48 weeks than the base line (t=2.3273 and t=3.6149).

CONCLUSIONS

PEG-IFN alfa-2a can effectively reduce HCV RNA loads in patients with HCV-/HIV co-infection, and the inhibition rate in patients with higher CD4 lymphocyte counts is better. The EVR and ETVR of the two groups of patients show similar results after the treatment. PEG-IFN alfa-2a can reduce the white blood cell counts and the blood platelet counts in the peripheral blood.

摘要

目的

评估聚乙二醇干扰素α-2a（PEG-IFNα-2a）与高效抗逆转录病毒疗法（HAART）联合治疗丙型肝炎病毒（HCV）合并人类免疫缺陷病毒（HIV）感染患者的临床疗效及副作用。

方法

22例HCV/HIV合并感染患者首先接受高效抗逆转录病毒治疗；待其CD4淋巴细胞计数升至0.20×10⁹/L以上后，分为两组：CD4淋巴细胞计数高于0.35×10⁹/L的一组（高组）和CD4淋巴细胞计数低于0.35×10⁹/L的一组（低组）。两组均每周肌肉注射180μg聚乙二醇干扰素α-2a。常规检测HCV RNA和HIV RNA载量、血细胞及CD4淋巴细胞计数以及肝功能。

结果

聚乙二醇干扰素α-2a治疗12周、24周和48周后，高组13例患者的平均HCV RNA载量较0周基线分别降低2.0650 log₁₀拷贝/ml（t = 3.8733）、2.9146 log₁₀拷贝/ml（t = 7.6741）和2.4315 log₁₀拷贝/ml（t = 5.8202），低组8例患者分别降低1.1522 log₁₀拷贝/ml（t = 2.8937）、1.4189 log₁₀拷贝/ml（t = 2.4422）和1.1167 log₁₀（t = 1.1261）。然而，两组的早期病毒应答率（EVR）和治疗结束时病毒应答率（ETVR）之间无显著差异。高组在24周时白细胞计数低于基线（t = 2.4700），在24周和48周时血小板计数均低于基线（t = 2.3273和t = 3.6149）。