Senturk H, Tahan V, Canbakan B, Uraz S, Ulger Y, Ozaras R, Tabak F, Mert A, Ozbay G
Department Gastroenterology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
Neth J Med. 2008 May;66(5):191-5.
The effect of conventional interferon-based therapy of hepatitis B virus (HBV) and hepatitis C virus (HCV) dual infection is controversial. Yet, no studies have been carried out into pegylated interferon treatment for chronic HBV/HCV coinfection. We aimed to evaluate the response rate and side effects of conventional or pegylated interferon combined with ribavirin on chronic HBV/HCV coinfection therapy.
The study included 36 chronic hepatitis patients (M/F: 28/8, mean age 47+/-12 years) who were positive for HBsAg and anti-HCV. They were tested for the presence of HBV-DNA by hybridisation assay, and the samples giving negative results were retested by polymerase chain reaction (PCR). All patients were tested for HCV-RNA using PCR, and the HCV genotype was determined.
Nineteen patients were given standard interferon either alone or in combination with ribavirin, whereas 17 were given pegylated interferon and ribavirin combination therapy. None of the patients had HBV-DNA positivity; however, all had HCV-RNA detectable by PCR. All the patients had HCV genotype 1b. The mean alanine aminotransferase and aspartate aminotransferase levels were 118+/-65 U/l and 90+/-95 U/l respectively. Five patients in each group discontinued the treatment due to side effects. Only two patients (one from each group) reached sustained virological response.
Neither pegylated nor conventional interferon based regimes were effective for HBV/HCV coinfection, in which the dominant virus was HCV. Pegylated interferon and ribavirin therapy was not superior to conventional interferon based regimes in the treatment of HBV/HCV coinfection.
基于传统干扰素治疗乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）双重感染的效果存在争议。然而，尚未开展聚乙二醇化干扰素治疗慢性HBV/HCV合并感染的研究。我们旨在评估传统或聚乙二醇化干扰素联合利巴韦林治疗慢性HBV/HCV合并感染的有效率和副作用。
该研究纳入了36例慢性肝炎患者（男/女：28/8，平均年龄47±12岁），这些患者HBsAg和抗-HCV均呈阳性。通过杂交试验检测HBV-DNA的存在情况，对结果为阴性的样本采用聚合酶链反应（PCR）进行重新检测。所有患者均采用PCR检测HCV-RNA，并确定HCV基因型。
19例患者单独或联合利巴韦林接受标准干扰素治疗，而17例患者接受聚乙二醇化干扰素和利巴韦林联合治疗。所有患者HBV-DNA均未呈阳性；然而，所有患者的HCV-RNA均可通过PCR检测到。所有患者的HCV基因型均为1b。平均丙氨酸转氨酶和天冬氨酸转氨酶水平分别为118±65 U/l和90±95 U/l。每组各有5例患者因副作用而停止治疗。只有2例患者（每组各1例）达到持续病毒学应答。
无论是聚乙二醇化干扰素还是基于传统干扰素的治疗方案对HBV/HCV合并感染均无效，其中占主导的病毒为HCV。在治疗HBV/HCV合并感染方面，聚乙二醇化干扰素和利巴韦林治疗并不优于基于传统干扰素的治疗方案。
