Jeong Soung Won, Kim Jin Dong, Woo Hyun Young, You Chan Ran, Lee Sung Won, Song Myeong Jun, Jang Jung Won, Bae Si Hyun, Choi Jong Young, Yoon Seung Kew
Department of Internal Medicine, College of Medicine, Soon Chun Hyang University, Korea.
Korean J Hepatol. 2009 Sep;15(3):338-49. doi: 10.3350/kjhep.2009.15.3.338.
BACKGROUND/AIMS: Various predictive factors for peginterferon alpha and ribavirin therapy in chronic hepatitis C have been reported, but the effect of adherence to therapy has not been established. We investigated how adherence affects the sustained virologic response (SVR).
We analyzed 92 chronic hepatitis C patients receiving peginterferon alpha and ribavirin combination therapy. Patients were first identified as having either genotype 1 or genotype non-1 infection and then categorized into three groups according to their adherence to the treatment protocol: (1) patients who received >/=80% of the recommended dosage of both peginterferon alpha and ribavirin for > or =80% of the intended duration of therapy, (2) patients who received <60% of the recommended dosage of both peginterferon alpha and ribavirin for <60% of the intended duration of therapy, and (3) patients who were not included in either group 1 or 2.
The rates of early virologic response, end of treatment response, and SVR differed significantly with the degree of adherence to the treatment. The SVRs of genotype 1 patients were 86.7%, 26.7%, and 66.7% in groups 1, 2, and 3, respectively (P=0.003), and those of genotype non-1 were 100%, 16.7%, and 88.9%, respectively (P<0.001).
Adherence to therapy is a key factor in achieving an SVR. Supportive strategies to improve adherence will increase overall SVR rates.
背景/目的：已有多种关于聚乙二醇干扰素α和利巴韦林治疗慢性丙型肝炎的预测因素的报道，但治疗依从性的影响尚未明确。我们研究了依从性如何影响持续病毒学应答（SVR）。
我们分析了92例接受聚乙二醇干扰素α和利巴韦林联合治疗的慢性丙型肝炎患者。首先将患者确定为基因型1或非基因型1感染，然后根据他们对治疗方案的依从性分为三组：（1）接受聚乙二醇干扰素α和利巴韦林推荐剂量的≥80%且治疗时间达到预期疗程的≥80%的患者；（2）接受聚乙二醇干扰素α和利巴韦林推荐剂量的<60%且治疗时间未达到预期疗程的<60%的患者；（3）不属于第1组或第2组的患者。
早期病毒学应答、治疗结束时应答和SVR率随治疗依从程度的不同而有显著差异。基因型1患者在第1、2、3组中的SVR率分别为86.7%、26.7%和66.7%（P = 0.003），非基因型1患者的SVR率分别为100%、16.7%和88.9%（P<0.001）。
治疗依从性是实现SVR的关键因素。改善依从性的支持性策略将提高总体SVR率。
