Sezaki Hitomi, Suzuki Fumitaka, Akuta Norio, Yatsuji Hiromi, Hosaka Tetsuya, Kobayashi Masahiro, Suzuki Yoshiyuki, Arase Yasuji, Ikeda Kenji, Miyakawa Yuzo, Kumada Hiromitsu
Department of Hepatology, Toranomon Hospital, Tokyo, Japan.
Intervirology. 2009;52(1):43-8. doi: 10.1159/000213504. Epub 2009 Apr 17.
Response to pegylated (PEG) interferon (IFN) and ribavirin is achieved only in 40-50% of patients infected with hepatitis C virus (HCV) of genotype 1 in high viral loads, which needs to be improved.
In an open-label pilot study, fluvastatin (HMG-CoA reductase inhibitor), 20 mg daily, was given along with PEG-IFN/ribavirin to 21 patients with chronic hepatitis C. They were followed for HCV RNA in serum.
During treatment for 48 weeks, HCV RNA was lost from serum in 93% of the patients. In the 15 patients who received 48-week therapy, a sustained virological response (SVR) with loss of HCV RNA 24 weeks after completion was achieved in 10 (67%), including 7 of the 9 (78%) male and 3 of the 6 (50%) female patients. In the remaining 6 patients who received 72-week therapy, SVR was gained in 4 (67%), including 1 of the 2 male and 3 of the 4 female patients aged 56, 58 and 62 years, respectively.
Fluvastatin could be used safely to increase the response to PEG-IFN and ribavirin, especially in aged women who respond poorly to combined PEG-IFN/ribavirin.
对于高病毒载量的1型丙型肝炎病毒(HCV)感染患者,聚乙二醇化(PEG)干扰素(IFN)和利巴韦林的治疗应答率仅为40%-50%,这一情况有待改善。
在一项开放标签的试点研究中,对21例慢性丙型肝炎患者给予每日20 mg氟伐他汀(HMG-CoA还原酶抑制剂)联合PEG-IFN/利巴韦林治疗。对他们的血清HCV RNA进行随访。
在48周的治疗期间,93%的患者血清中HCV RNA消失。在接受48周治疗的15例患者中,10例(67%)在完成治疗后24周实现了持续病毒学应答(SVR),HCV RNA消失,其中包括9例男性患者中的7例(78%)和6例女性患者中的3例(50%)。在其余接受72周治疗的6例患者中,4例(67%)实现了SVR,其中包括2例男性患者中的1例以及分别为56岁、58岁和62岁年龄的4例女性患者中的3例。
氟伐他汀可安全用于提高对PEG-IFN和利巴韦林的应答,尤其是对PEG-IFN/利巴韦林联合治疗应答不佳的老年女性患者。