Nguyen Mindie H, Trinh Huy N, Garcia Ruel, Nguyen Gloria, Lam Khoa D, Keeffe Emmet B
Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California, USA.
Am J Gastroenterol. 2008 May;103(5):1131-5. doi: 10.1111/j.1572-0241.2008.01793.x.
Infection with hepatitis C virus (HCV) genotype 6 is common in patients from parts of China and Southeast Asia. No study to date has examined the treatment response to peginterferon and ribavirin (PEG IFN + RBV) in these patients, or the effects of treatment duration on sustained virologic response (SVR) rates.
We performed a retrospective study of 190 consecutive Asian-American patients who were diagnosed with HCV genotype 6 at a gastroenterology clinic in northern California between 2001 and 2004, 66 of whom were treatment-naïve and subsequently completed 24 wk of IFN + RBV or PEG IFN + RBV or 48 wk of PEG IFN + RBV therapy. The primary outcome was SVR.
There was no statistical difference in SVR of 31 patients treated with 24 wk of IFN + RBV and in 23 patients treated with 24 wk of PEG IFN + RBV (51.6%vs 39%, P= 0.363). The SVR in 12 patients treated with 48 wk of PEG IFN + RBV was significantly higher than that in those treated for only 24 wk (75%vs 39%, P= 0.044).
Treatment-eligible patients with HCV genotype 6 should be treated with a full course of 48 wk as tolerated. Larger prospective studies of patients with HCV genotype 6 are needed to confirm the optimal treatment duration with PEG IFN + RBV.
丙型肝炎病毒（HCV）6型感染在中国部分地区和东南亚患者中很常见。迄今为止，尚无研究考察这些患者接受聚乙二醇干扰素和利巴韦林（PEG IFN + RBV）治疗的反应，或治疗疗程对持续病毒学应答（SVR）率的影响。
我们对2001年至2004年期间在加利福尼亚州北部一家胃肠病诊所被诊断为HCV 6型的190例连续的亚裔美国患者进行了一项回顾性研究，其中66例既往未接受过治疗，随后完成了24周的IFN + RBV或PEG IFN + RBV治疗或48周的PEG IFN + RBV治疗。主要结局为SVR。
接受24周IFN + RBV治疗的31例患者与接受24周PEG IFN + RBV治疗的23例患者的SVR无统计学差异（51.6%对39%，P = 0.363）。接受48周PEG IFN + RBV治疗的12例患者的SVR显著高于仅接受24周治疗的患者（75%对39%，P = 0.044）。
符合治疗条件的HCV 6型患者应在耐受的情况下接受48周的全程治疗。需要对HCV 6型患者进行更大规模的前瞻性研究，以确认PEG IFN + RBV的最佳治疗疗程。
