Jeong Soocheol, Kawakami Yoshiiku, Kitamoto Mikiya, Ishihara Hiroto, Tsuji Keiji, Aimitsu Shiomi, Kawakami Hiroiku, Uka Kiminori, Takaki Shintaro, Kodama Hideaki, Waki Koji, Imamura Michio, Aikata Hiroshi, Takahashi Shoichi, Chayama Kazuaki
Department of Medicine and Molecular Science, Hiroshima University, Hiroshima, Japan.
J Gastroenterol Hepatol. 2008 Apr;23(4):541-5. doi: 10.1111/j.1440-1746.2008.05356.x.
Long-term interferon (IFN) therapy is effective in eliminating hepatitis C virus (HCV). However, it carries the risk of adverse effects and reduced quality of life. To assess whether short-term IFN therapy effectively eliminates HCV, we performed a prospective pilot study of pegylated (peg)IFN-alpha-2a therapy for 8 or 24 weeks.
After excluding patients with high titers of genotype-1, 55 HCV patients received pegIFN-alpha-2a. Patients who became negative for HCV-RNA at week 2 were allocated to either an 8-week (n = 19) or 24-week (n = 15) course of IFN. We evaluated the efficacy of and tolerance to IFN therapy.
The sustained virological response rate was excellent in the two groups (8 weeks, 89.5% [17/19]; 24 weeks, 100% [15/15], respectively,). IFN dose reduction was required in one patient of the 8-week group, but in six patients of the 24-week group (P = 0.028). Treatment was completed by all patients of the 8-week group, but discontinued in five patients of the 24-week group (P = 0.011).
The 8-week IFN therapy is more tolerable than the 24-week therapy and had similar outcomes. Excluding the patients with high titers of genotype-1, we recommend switching to an 8-week course of pegIFN-alpha monotherapy once patients show an ultra rapid virological response at week 2 from the start of IFN therapy.
长期干扰素（IFN）治疗对清除丙型肝炎病毒（HCV）有效。然而，它存在不良反应风险且会降低生活质量。为评估短期IFN治疗能否有效清除HCV，我们开展了一项关于聚乙二醇化（peg）IFN-α-2a治疗8周或24周的前瞻性试点研究。
排除基因1型高滴度患者后，55例HCV患者接受了pegIFN-α-2a治疗。在第2周时HCV-RNA转为阴性的患者被分配至8周疗程组（n = 19）或24周疗程组（n = 15）。我们评估了IFN治疗的疗效和耐受性。
两组的持续病毒学应答率均极佳（8周组为89.5%[17/19]；24周组为百分之百[15/15]）。8周组有1例患者需要减少IFN剂量，而24周组有6例患者需要减少剂量（P = 0.028）。8周组的所有患者均完成了治疗，而24周组有5例患者中断了治疗（P = 0.011）。
8周IFN治疗比24周治疗耐受性更好，且疗效相似。排除基因1型高滴度患者后，我们建议一旦患者在IFN治疗开始后的第2周显示出超快速病毒学应答，就改用8周疗程的pegIFN-α单药治疗。
