Akhan S C, Kalender B, Ruzgar M
Infectious Diseases and Clinical Microbiology, Kocaeli University Medical Faculty, Umuttepe, 41380, Kocaeli, Turkey.
Infection. 2008 Aug;36(4):341-4. doi: 10.1007/s15010-008-7134-z. Epub 2008 Jul 15.
The aim of this retrospective study was to focus the efficacy of pegylated interferon (PEG-IFN) alpha 2a in chronic hemodialysis patients with hepatitis C and to compare the therapy responses with other chronic hepatitis C patients. Of the anti-HCV positive patients who were admitted to the Infectious Diseases and Clinical Microbiology policlinic from January 2004 to December 2006, 99 were candidates for interferon therapy. Of those, 12 patients were on HD. We began 47 patients on PEG-IFN alpha 2a (180 lg/week) subcutaneously plus ribavirin (1,000-1,200 mg/day) (Group 1), and 12 patients on HD, PEG-IFN alpha 2a, without ribavirin at a dose of 135 lg weekly for 48 weeks (Group 2). In this study of PEG IFN alpha 2a with or without ribavirin, the predictability of a sustained viral response (SVR) was based on the early virologic response (EVR) defined at week 12 as an at least 2-log decline from baseline of the HCV RNA level. About 77% (39/47) of patients achieved an EVR in Group 1 and 58% (7/12) in Group 2 (p = 0.004). A total of 34 (72.34%) patients in Group 1 and 6 patients (50%) in Group 2 had negative HCV RNA at the end of the treatment (p = 0.213). We evaluated SVR after 6 months finishing the therapy; 29 (61.7%) patients in Group 1 and 6 patients (50%) in Group 2 had negative HCV RNA (p = 0.109). PEG-IFN alpha 2a (135 lg weekly) for 48 weeks is efficacious and well tolerated in HD patients with HCV, as well as other chronic HCV patients. However, due to more side effects of IFN specially on platelet counts as compared non-renal HCV patients a closer follow-up, in HD patients is suggested.
这项回顾性研究的目的是聚焦聚乙二醇化干扰素（PEG-IFN）α-2a对慢性丙型肝炎血液透析患者的疗效，并将治疗反应与其他慢性丙型肝炎患者进行比较。在2004年1月至2006年12月入住传染病与临床微生物学门诊的抗-HCV阳性患者中，99例符合干扰素治疗条件。其中，12例患者正在接受血液透析。我们让47例患者皮下注射PEG-IFNα-2a（180μg/周）加利巴韦林（1000 - 1200mg/天）（第1组），12例接受血液透析的患者，皮下注射PEG-IFNα-2a，不使用利巴韦林，剂量为每周135μg，共48周（第2组）。在这项关于有或没有利巴韦林的PEG IFNα-2a的研究中，持续病毒学应答（SVR）的可预测性基于第12周定义的早期病毒学应答（EVR），即HCV RNA水平相对于基线至少下降2个对数。第1组约77%（39/47）的患者实现了EVR，第2组为58%（7/12）（p = （此处原文有误，推测应为0.004））。治疗结束时，第1组共有34例（72.34%）患者和第2组6例（50%）患者的HCV RNA呈阴性（p = 0.213）。我们在完成治疗6个月后评估SVR；第1组29例（61.7%）患者和第2组6例（50%）患者的HCV RNA呈阴性（p = 0.109）。PEG-IFNα-2a（每周135μg）治疗48周对丙型肝炎血液透析患者以及其他慢性丙型肝炎患者有效且耐受性良好。然而，由于与非肾性丙型肝炎患者相比，干扰素尤其是对血小板计数有更多副作用，建议对血液透析患者进行更密切的随访。
