Gastroenterology and Hepatology Service, Hospital Universitario de La Princesa, Autonomous University of Madrid, and Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
J Clin Pharm Ther. 2011 Dec;36(6):695-703. doi: 10.1111/j.1365-2710.2010.01231.x. Epub 2010 Dec 22.
Interferon-alfa-based therapy is effective in the treatment of Hepatitis C. However, some patients fail to respond and others relapse, after initially responding. Our objective was to assess the efficacy, safety and predictive factors for sustained virological response (SVR) to peginterferon plus ribavirin in chronic hepatitis C patients who failed to interferon-alfa (IFNα)-based therapy.
Seventy-five consecutive patients who failed to IFNα-based therapy were retreated with peginterferon plus ribavirin. Of these patients, 85% were infected by genotype 1. The primary endpoint was SVR.
Of 75 non-responder (n = 54) or relapser patients (n = 21), 50 were previously treated with IFNα-monotherapy and 25 with IFNα plus ribavirin. Global SVR rate was 41.3%: for patients re-treated with IFNα the response was 48% whilst for those retreated with IFNα plus ribavirin, it was 28%. For previous non-responders the SVR rate was 37% and for relapsers it was 52.4%.
Retreatment with peginterferon plus ribavirin is an effective option for some chronic hepatitis C non-responder or relapser patients. Higher SVR rate was achieved in relapsers and in those patients who received IFNα monotherapy previously.
基于干扰素-α的治疗在丙型肝炎的治疗中是有效的。然而，一些患者在最初应答后未能应答，而另一些患者则在应答后复发。我们的目的是评估聚乙二醇干扰素加利巴韦林在对干扰素-α（IFNα）治疗无应答的慢性丙型肝炎患者中的疗效、安全性和持续病毒学应答（SVR）的预测因素。
75 例对 IFNα 治疗无应答的连续患者用聚乙二醇干扰素加利巴韦林进行再治疗。这些患者中有 85%感染了基因型 1。主要终点是 SVR。
在 54 例无应答（n=54）或复发（n=21）患者中，50 例患者先前接受过 IFNα 单药治疗，25 例患者接受过 IFNα 加利巴韦林治疗。总的 SVR 率为 41.3%：用 IFNα 再治疗的患者应答率为 48%，而用 IFNα 加利巴韦林再治疗的患者应答率为 28%。以前无应答者的 SVR 率为 37%，复发者为 52.4%。
用聚乙二醇干扰素加利巴韦林再治疗是一些慢性丙型肝炎无应答或复发患者的有效选择。在复发患者和以前接受 IFNα 单药治疗的患者中，SVR 率更高。
