Infectious Diseases Clinic, Department of Medicine and Science of Ageing. G. d'Annunzio University, Chieti-Pescara, Italy.
J Med Virol. 2010 Jan;82(1):49-56. doi: 10.1002/jmv.21657.
The aim of the study was to evaluate the effects of epoetin-beta on anemia and sustained viral response in patients with chronic hepatitis C receiving treatment with pegylated interferon and ribavirin. Forty-two Caucasian patients with chronic hepatitis C infection, treated with pegylated interferon alpha-2a or alpha-2b plus ribavirin, who experienced at least a 2 log decline in HCV-RNA in the first month of therapy and a > or =2.5 g/dl hemoglobin drop from baseline, were recruited. They were divided into two groups: 22 patients received epoetin-beta 30,000 U administered s.c. q.w. (group A) and 20 patients received a reduced ribavirin dose of 600 mg daily (group B). The end-of-treatment response was 95.4% (21/22) in group A and 80% (16/20) (P = 0.2) in group B. Sustained viral response in group A was 81.8% (18/22), statistically higher than in group B (45%, 9/20) (P = 0.03). Mean corpuscular volume of erythrocytes was statistically lower in group A than in group B 4 weeks after starting epoetin-beta or reduced ribavirin dose (P < 0.001), end-of-treatment (P < 0.001) and after 6 months follow-up (P < 0.001). A negative correlation between the levels of ferritin serum was found in group A at the baseline and mean corpuscular volume value after 1 month of combination antiviral therapy (r = -0.45; P = 0.35), 4 weeks after starting epoetin-beta (r = -0.43; P = 0.04) and after 6 months follow-up (r = -0.45; P = 0.03). Administration of epoetin-beta increases sustained viral response rates among patients developing anemia, because the standard dose of ribavirin is maintained, thereby reducing the side-effects of antiviral treatment.
这项研究的目的是评估 epoetin-beta 对接受聚乙二醇干扰素和利巴韦林治疗的慢性丙型肝炎患者贫血和持续病毒应答的影响。招募了 42 名慢性丙型肝炎感染的白种人患者，他们接受了聚乙二醇干扰素 alpha-2a 或 alpha-2b 加利巴韦林治疗，在治疗的第一个月内 HCV-RNA 至少下降了 2 个对数，并且血红蛋白从基线下降了 > 或 = 2.5 g/dl。他们被分为两组：22 名患者接受皮下注射 epoetin-beta 30000 U，每周一次（A 组），20 名患者接受每日 600 mg 的利巴韦林剂量减少（B 组）。A 组的治疗结束时应答率为 95.4%（21/22），B 组为 80%（16/20）（P = 0.2）。A 组的持续病毒应答率为 81.8%（18/22），明显高于 B 组（45%，9/20）（P = 0.03）。开始 epoetin-beta 或减少利巴韦林剂量后 4 周（P < 0.001）、治疗结束时（P < 0.001）和 6 个月随访时（P < 0.001），A 组的平均红细胞体积低于 B 组。在 A 组中，在开始联合抗病毒治疗后 1 个月的基线和平均红细胞体积值之间发现了血清铁蛋白水平的负相关（r = -0.45；P = 0.35），在开始 epoetin-beta 后 4 周（r = -0.43；P = 0.04）和 6 个月随访时（r = -0.45；P = 0.03）。给予 epoetin-beta 可提高发生贫血的患者的持续病毒应答率，因为维持利巴韦林的标准剂量，从而减少抗病毒治疗的副作用。
