Department of Medicine and Geriatrics of Princess Margaret Hospital, Hong Kong.
J Gastroenterol Hepatol. 2010 Apr;25(4):766-71. doi: 10.1111/j.1440-1746.2009.06163.x.
Chronic hepatitis C genotype 6 is common in Hong Kong, especially among i.v. drug abusers. Responses of these patients to combination of pegylated interferon and ribavirin treatment were inconsistent and the numbers of patients involved in previous studies were small. We performed a retrospective study to compare the therapeutic responses of this regimen in patients infected with genotype 6 and genotype 1.
Seventy patients with either genotype 6 or genotype 1 were recruited. Both groups received 800-1200 mg of ribavirin daily plus either 180 mg of pegylated alpha-interferon-2a or 1.5 mg/kg pegylated alpha-interferon-2b weekly for 48 weeks. Their responses to treatments were compared.
The early virological response to combination therapy of patients with genotype 6 was significantly better than that of genotype 1 (88.6% vs 74.3%, P = 0.03). Significant difference was also identified in the end of treatment response of the two genotypes (60% vs 81.4% for genotype 1 and 6, respectively; P = 0.005). The sustained virological response (SVR) to treatment in patients with genotype 6 was also significantly superior to that of patients with genotype 1 (75.7% vs 57.1%, P = 0.02). Multiple logistic regression analysis demonstrated that age of 55 years or less, genotypes of hepatitis C virus, liver biopsy staging and baseline hepatitis C virus RNA of 200,000 IU/mL or less were independent predictors for better SVR in this cohort.
Patients with chronic hepatitis C genotype 6 respond better to pegylated interferon and ribavirin combination treatment than patients with genotype 1.
慢性丙型肝炎基因型 6 在香港很常见,尤其是在静脉注射毒品的人群中。既往研究中,该基因型患者对聚乙二醇干扰素和利巴韦林联合治疗的反应不一致,且涉及的患者数量较少。本研究旨在比较基因型 6 和基因型 1 感染患者对该方案治疗的反应。
本研究纳入了 70 例基因型 6 或基因型 1 的患者。两组患者均接受 800-1200mg 利巴韦林联合 180mg 聚乙二醇干扰素-α-2a 或 1.5mg/kg 聚乙二醇干扰素-α-2b 每周 1 次,疗程 48 周。比较两组患者的治疗反应。
基因型 6 患者联合治疗的早期病毒学应答明显优于基因型 1 患者(88.6% vs 74.3%,P = 0.03)。两组患者的治疗结束时应答也存在显著差异(基因型 1 和 6 患者的完全应答率分别为 81.4%和 60%,P = 0.005)。基因型 6 患者的持续病毒学应答(SVR)也明显优于基因型 1 患者(75.7% vs 57.1%,P = 0.02)。多因素 logistic 回归分析显示,年龄≤55 岁、丙型肝炎病毒基因型、肝活检分期和基线丙型肝炎病毒 RNA<200000IU/ml 是该队列中 SVR 的独立预测因素。
慢性丙型肝炎基因型 6 患者对聚乙二醇干扰素和利巴韦林联合治疗的反应优于基因型 1 患者。