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一种新型丙型肝炎病毒核心抗原免疫放射分析方法在预测聚乙二醇干扰素/利巴韦林联合治疗高血清丙型肝炎病毒RNA 1b基因型载量的慢性肝炎患者病毒学应答中的应用价值

Usefulness of a new immunoradiometric assay of HCV core antigen to predict virological response during PEG-IFN/RBV combination therapy for chronic hepatitis with high viral load of serum HCV RNA genotype 1b.

作者信息

Sasase Noriko, Kim Soo Ryang, Kim Ke Ih, Taniguchi Miyuki, Imoto Susumu, Mita Keiji, Hotta Hak, Shouji Ikuo, El-Shamy Ahmed, Kawada Norifumi, Kudo Masatoshi, Hayashi Yoshitake

机构信息

Department of Pharmacy, Kobe Asahi Hospital, Kobe, Japan.

出版信息

Intervirology. 2008;51 Suppl 1:70-5. doi: 10.1159/000122601. Epub 2008 Jun 10.

Abstract

We investigated the clinical usefulness of a new immunoradiometric (IRM) assay of hepatitis C virus (HCV) core antigen in predicting virological response during pegylated interferon plus ribavirin (PEG-IFN/RBV) combination therapy for chronic hepatitis with high viral loads of serum HCV RNA genotype 1b. Thirty-nine patients received a regimen of PEG-IFNalpha-2b (1.5 microg/kg/week s.c.) in combination with RBV (600-1,000 mg/day). Of the 39 patients, 18 (46.2%) achieved sustained virological response (SVR), 11 (28.2%) attained partial response (PR) and 10 (25.6%) showed no response (NR). Four weeks after the start of therapy, 1- and 2-log reductions in the amount of HCV core antigen were observed in 20 (2/10) and 0% (0/10) showing NR, 91 (10/11) and 63.6% (7/11) with PRs, and 88.9 (16/18) and 55.6% (10/18) of patients with SVR, respectively. The 1- and 2-log reductions 4 weeks after the start of therapy were not a defining condition for PR and SVR. The amount of HCV core antigen was significantly different between SVR and PR patients on days 1 and 7, and between patients with NR and SVR at all points of time. In conclusion, this new IRM assay is useful in predicting virological response during PEG-IFN/RBV therapy.

摘要

我们研究了一种新的丙型肝炎病毒(HCV)核心抗原免疫放射测定法(IRM)在预测聚乙二醇干扰素联合利巴韦林(PEG-IFN/RBV)治疗血清HCV RNA 1b基因型高病毒载量的慢性肝炎患者的病毒学应答方面的临床实用性。39例患者接受了PEG-IFNα-2b(1.5μg/kg/周皮下注射)联合利巴韦林(600-1000mg/天)的治疗方案。在这39例患者中,18例(46.2%)实现了持续病毒学应答(SVR),11例(28.2%)达到部分应答(PR),10例(25.6%)无应答(NR)。治疗开始4周后,无应答患者中分别有20例(2/10)和0%(0/10)观察到HCV核心抗原量下降1个对数和2个对数,部分应答患者中分别有91%(10/11)和63.6%(7/11),持续病毒学应答患者中分别有88.9%(16/18)和55.6%(10/18)。治疗开始4周后下降1个对数和2个对数并非部分应答和持续病毒学应答的决定性条件。在第1天和第7天以及在所有时间点,持续病毒学应答和部分应答患者之间以及无应答和持续病毒学应答患者之间的HCV核心抗原量存在显著差异。总之,这种新的免疫放射测定法在预测PEG-IFN/RBV治疗期间的病毒学应答方面是有用的。

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