Tsubota Akihito, Satoh Ken-ichi, Aizawa Mashu, Takamatsu Seishi, Namiki Yoshihisa, Ohkusa Toshifumi, Fujise Kiyotaka, Tajiri Hisao
Institute of Clinical Medicine and Research, Jikei University School of Medicine, 163-1 Kashiwa-shita, Kashiwa, Chiba 277-8567, Japan.
World J Gastroenterol. 2008 Dec 21;14(47):7220-4. doi: 10.3748/wjg.14.7220.
To assess the efficacy and advantages of 4-wk pegylated interferon alpha-2a (peg-IFN-alpha 2a) monotherapy for chronic hepatitis C patients with strong predictors of sustained virologic response (SVR).
Patients (n = 33) with genotype 2 and low viral load (< 100 KIU/mL), who became HCV RNA negative after 1 wk of IFN treatment, were randomly allocated to receive a 4- or 12-wk treatment course at a ratio of 2:1, respectively, with a subsequent 24-wk follow-up period. Peg-IFN-alpha 2a was administered subcutaneously at a dose of 180 microg or 90 microg once weekly. SVR was defined as absence of serum HCV RNA at the end of the follow-up period.
All patients completed the treatment schedule, and more than half were symptom-free during the treatment. In the 4-wk treatment group, 20 of 22 (91%) patients achieved SVR. Two patients relapsed, but achieved SVR following re-treatment with peg-IFN-alpha 2a alone. In the 12-wk treatment group, 11 of 11 (100%) patients attained SVR.
Our results show that a 4-wk course of peg-IFN-alpha 2a monotherapy can achieve a high SVR rate in "IFN-sensitive" patients, without negatively affecting outcome.
评估4周聚乙二醇化干扰素α-2a（peg-IFN-α 2a）单药治疗对具有持续病毒学应答（SVR）强预测指标的慢性丙型肝炎患者的疗效及优势。
对33例基因2型且病毒载量低（<100 KIU/mL）、在干扰素治疗1周后HCV RNA转阴的患者，分别按2:1的比例随机分配接受4周或12周的治疗疗程，随后进行24周的随访。Peg-IFN-α 2a以180μg或90μg的剂量皮下注射，每周1次。SVR定义为随访期末血清HCV RNA阴性。
所有患者均完成治疗方案，超过半数患者在治疗期间无症状。在4周治疗组中，22例患者中有20例（91%）实现SVR。2例患者复发，但仅用peg-IFN-α 2a再次治疗后实现SVR。在12周治疗组中，11例患者中有11例（100%）实现SVR。
我们的结果表明，4周疗程的peg-IFN-α 2a单药治疗可在“干扰素敏感”患者中实现高SVR率，且不影响治疗结果。
