Gonzalez Stevan A, Keeffe Emmet B
Division of Hepatology, Baylor Regional Transplant Institute, Baylor All Saints Medical Center, Fort Worth and Baylor University Medical Center, Dallas, TX, USA.
Biologics. 2009;3:141-50. Epub 2009 Jul 13.
A significant proportion of patients with chronic hepatitis C virus (HCV) infection who undergo antiviral therapy have persistent or recurrent viremia and fail to achieve a sustained virologic response (SVR). Factors associated with treatment failure include HCV genotype 1 infection, high serum HCV RNA levels, and advanced fibrosis. Consensus interferon (CIFN) is a synthetic type I interferon derived from a consensus sequence of the most common amino acids found in naturally occurring alpha interferon subtypes. Several prospective clinical studies have demonstrated that CIFN may be a treatment option in patients who have failed prior interferon-based therapy, including those who have failed combination therapy with standard interferon or peginterferon plus ribavirin. Daily CIFN in combination with ribavirin may be an effective regimen in this setting; however, optimal dose and treatment duration of CIFN therapy have not been well established. Patients who achieve viral suppression during prior interferon-based therapy and those who do not have advanced fibrosis have a greater likelihood of achieving a SVR with CIFN retreatment. Individualized therapy targeting specific patient groups will be an important consideration in the successful management of prior treatment failures. Additional prospective studies are required in order to identify optimal treatment strategies for the use of CIFN in these patients.
接受抗病毒治疗的慢性丙型肝炎病毒（HCV）感染患者中，有很大一部分存在持续性或复发性病毒血症，未能实现持续病毒学应答（SVR）。与治疗失败相关的因素包括HCV 1型感染、高血清HCV RNA水平和严重纤维化。共识干扰素（CIFN）是一种合成的I型干扰素，源自天然存在的α干扰素亚型中最常见氨基酸的共有序列。多项前瞻性临床研究表明，对于先前基于干扰素的治疗失败的患者，包括那些标准干扰素或聚乙二醇干扰素联合利巴韦林联合治疗失败的患者，CIFN可能是一种治疗选择。在这种情况下，每日CIFN联合利巴韦林可能是一种有效的治疗方案；然而，CIFN治疗的最佳剂量和疗程尚未明确确定。在先前基于干扰素的治疗期间实现病毒抑制的患者以及没有严重纤维化的患者，再次使用CIFN治疗实现SVR的可能性更大。针对特定患者群体的个体化治疗将是成功管理先前治疗失败患者的重要考虑因素。需要进行更多的前瞻性研究，以确定在这些患者中使用CIFN的最佳治疗策略。
