聚乙二醇化干扰素α2a联合利巴韦林与聚乙二醇化干扰素α2b联合利巴韦林治疗HIV感染患者的慢性丙型肝炎

Pegylated interferon {alpha}2a plus ribavirin versus pegylated interferon {alpha}2b plus ribavirin for the treatment of chronic hepatitis C in HIV-infected patients.

作者信息

Berenguer J, González-García J, López-Aldeguer J, Von-Wichmann M A, Quereda C, Hernando A, Sanz J, Tural C, Ortega E, Mallolas J, Santos I, Miralles P, Montes M L, Bellón J M, Esteban H

机构信息

Hospital Gregorio Marañón, Madrid, Spain.

出版信息

J Antimicrob Chemother. 2009 Jun;63(6):1256-63. doi: 10.1093/jac/dkp106. Epub 2009 Apr 10.

DOI:10.1093/jac/dkp106

PMID:19363085

Abstract

OBJECTIVES

The two currently available types of pegylated interferon (peg-IFN) used to treat hepatitis C have different pharmacokinetic properties. It is unclear how these differences affect response to therapy. We compared the effectiveness and safety of peg-IFN-alpha2a and peg-IFN-alpha2b, both with ribavirin, against chronic hepatitis C virus (HCV) infection in HIV-infected patients.

METHODS

From the GESIDA HIV/HCV cohort, we analysed patients treated with peg-IFN-alpha2a (n = 315) or peg-IFN-alpha2b (n = 242). The primary endpoint was a sustained virological response (SVR).

RESULTS

Both groups were well matched in baseline characteristics except for a higher frequency of injection drug users in the peg-IFN-alpha2b group than in the peg-IFN-alpha2a group (85% versus 76%; P = 0.01) and a higher frequency of bridging fibrosis and cirrhosis (F3-F4) in the peg-IFN-alpha2b group than in the peg-IFN-alpha2a group (42% versus 33%; P = 0.04). End-of-treatment response was significantly lower among patients treated with peg-IFN-alpha2b [40% versus 52%; odds ratio (OR), 1.63; 95% confidence interval (95% CI), 1.16-2.29; P < 0.01]. However, no significant differences were found in SVR between patients treated with peg-IFN-alpha2b and those treated with peg-IFN-alpha2a (31% versus 33%; OR, 1.09; 95% CI, 0.75-1.59; P = 0.655). Therapy was interrupted due to adverse events in 33 (14%) patients treated with peg-IFN-alpha2b and 47 (15%) patients treated with peg-IFN-alpha2a.

CONCLUSIONS

No differences in effectiveness and safety were found between peg-IFN-alpha2b and peg-IFN-alpha2a for the treatment of chronic HCV infection in HIV-infected patients.

摘要

目的

目前用于治疗丙型肝炎的两种聚乙二醇化干扰素（peg-IFN）具有不同的药代动力学特性。尚不清楚这些差异如何影响治疗反应。我们比较了聚乙二醇化干扰素α2a和聚乙二醇化干扰素α2b联合利巴韦林治疗人类免疫缺陷病毒（HIV）感染患者慢性丙型肝炎病毒（HCV）感染的有效性和安全性。

方法

从GESIDA HIV/HCV队列中，我们分析了接受聚乙二醇化干扰素α2a（n = 315）或聚乙二醇化干扰素α2b（n = 242）治疗的患者。主要终点是持续病毒学应答（SVR）。

结果

除聚乙二醇化干扰素α2b组注射吸毒者的频率高于聚乙二醇化干扰素α2a组（85%对76%；P = 0.01）以及聚乙二醇化干扰素α2b组桥接纤维化和肝硬化（F3-F4）的频率高于聚乙二醇化干扰素α2a组（42%对33%；P = 0.04）外，两组在基线特征方面匹配良好。接受聚乙二醇化干扰素α2b治疗的患者治疗结束时的应答率显著较低[40%对52%；优势比（OR），1.63；95%置信区间（95%CI），1.16 - 2.29；P < 0.01]。然而，接受聚乙二醇化干扰素α2b治疗的患者与接受聚乙二醇化干扰素α2a治疗的患者在SVR方面未发现显著差异（31%对33%；OR，1.09；95%CI，0.75 - 1.59；P = 0.655）。接受聚乙二醇化干扰素α2b治疗的33例（14%）患者和接受聚乙二醇化干扰素α2a治疗的47例（15%）患者因不良事件中断治疗。