Weiland O, Hollander A, Mattsson L, Glaumann H, Lindahl K, Schvarcz R, Lindh G, Enquist R, Quist A
Division of Infectious Diseases, Department of Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden.
J Viral Hepat. 2008 Sep;15(9):641-5. doi: 10.1111/j.1365-2893.2008.00999.x. Epub 2008 May 27.
Mono-therapy with pegylated interferon (peg-IFN) has shown that a lower-than-standard dose yields the same sustained viral response (SVR) rates as standard doses for chronic hepatitis C virus (HCV) infection caused by genotypes 2 or 3. Our aim was to see if a fixed, lower-than-standard dose of peg-IFN alfa-2a (135 microg weekly) in combination with ribavirin 11 mg/kg daily for 24 weeks yields sufficient SVR rates for genotypes 2 or 3. Hundred consecutive patients with a mean age of 44 years (range 20-69 years), 59 with genotype 3 and 41 with genotype 2, were studied. Rapid viral response (RVR) with HCV-RNA <15 IU/mL at treatment week 4 and SVR were calculated. RVR was achieved by 28/40 (70%) patients with genotype 2 and 41/58 (71%) with genotype 3. Significantly more genotype 2 patients with RVR achieved SVR 27/28 (96%) than genotype 2 patients who failed to achieve RVR, 8/12 (66%), P = 0.009. The corresponding figures for genotype 3 patients were 39/41 (95%) vs 11/17 (65%), respectively, P = 0.002. In total, SVR was achieved by 35/41 (85%) patients with genotype 2 and 51/59 (86%) patients with genotype 3, respectively. We found that 135 microg peg-IFN alfa-2a weekly was sufficient for treatment of genotype 2 and 3 chronic hepatitis C when combined with RBV dosed daily according to body weight. This combination yielded high SVR rates (85-86%) and may be cost-saving.
聚乙二醇化干扰素（peg-IFN）单药治疗已表明，对于由2型或3型基因型引起的慢性丙型肝炎病毒（HCV）感染，低于标准剂量可产生与标准剂量相同的持续病毒学应答（SVR）率。我们的目的是观察固定的、低于标准剂量的聚乙二醇化干扰素α-2a（每周135微克）联合利巴韦林每日11毫克/千克治疗24周，对于2型或3型基因型是否能产生足够的SVR率。对连续100例平均年龄44岁（范围20 - 69岁）的患者进行了研究，其中59例为3型基因型，41例为2型基因型。计算治疗第4周时HCV-RNA<15 IU/mL的快速病毒学应答（RVR）和SVR。2型基因型患者中有28/40（70%）、3型基因型患者中有41/58（71%）实现了RVR。2型基因型中实现RVR的患者有27/28（96%）达到SVR，显著高于未实现RVR的2型基因型患者8/12（66%），P = 0.009。3型基因型患者的相应数据分别为39/41（95%）和11/17（65%），P = 0.002。总体而言，2型基因型患者中有35/41（85%）、3型基因型患者中有51/59（86%）实现了SVR。我们发现，当每周135微克聚乙二醇化干扰素α-2a与根据体重每日给药的利巴韦林联合使用时，足以治疗2型和3型慢性丙型肝炎。这种联合治疗产生了高SVR率（85 - 86%），并且可能节省成本。
