Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon Department of Gastroenterology, Ehime Prefectural Central Hospital Center for Liver-Biliary-Pancreatic Diseases, Matsuyama Red Cross Hospital Department of Internal Medicine, Saiseikai Matsuyama Hospital, Matsuyama Department of Internal Medicine, Uwajima City Hospital, Uwajima Department of Internal Medicine, Saiseikai Saijo Hospital, Saijo Department of Internal Medicine, Ehime Prefectural Imabari Hospital Department of Internal Medicine, Saiseikai Imabari Daini Hospital, Imabari, Japan.
Hepatol Res. 2011 Aug;41(8):722-30. doi: 10.1111/j.1872-034X.2011.00816.x. Epub 2011 Jun 17.
Patients infected with hepatitis C virus (HCV) genotype 2 are more sensitive to interferon (IFN) therapy than those infected with genotype 1, but 10-20% of patients do not achieve a sustained viral response (SVR) to combination therapy with pegylated (PEG) IFN and ribavirin (RBV). This study examines the prognostic factors associated with SVR in patients infected with HCV genotype 2 treated with PEG IFN and RBV.
We treated 149 patients with chronic hepatitis C caused by HCV genotype 2. The patients received s.c. PEG IFN-α-2b (1.5 µg/kg) and a weekly weight-adjusted dose of RBV (600, 800 and 1000 mg per <60, 60-80 and >80 kg, respectively) for 24 weeks and then prognostic factors associated with the SVR were examined.
Among the 149 patients, 138 completed the combination therapy and a sustained viral response was achieved in 71.8% of them. Univariate analysis showed that age, as well as mean RBV and PEG IFN doses were factors affecting the SVR (P = 0.012, =0.021, =0.014). Multivariate analysis identified age and mean PEG IFN dose (P = 0.021, =0.018, respectively) as factors involved in the SVR, but not mean RBV dose.
The SVR of patients infected with HCV genotype 2 depended on the dosage of PEG IFN, but not of RBV. Selecting sufficient doses of PEG IFN for combination with RBV is critical for treating such patients.
感染丙型肝炎病毒（HCV）基因型 2 的患者对干扰素（IFN）治疗比感染基因型 1 的患者更敏感，但 10-20%的患者对聚乙二醇（PEG）干扰素和利巴韦林（RBV）联合治疗不能获得持续病毒应答（SVR）。本研究探讨了接受 PEG IFN 和 RBV 治疗的 HCV 基因型 2 感染患者获得 SVR 的相关预后因素。
我们治疗了 149 例由 HCV 基因型 2 引起的慢性丙型肝炎患者。这些患者接受皮下注射 PEG IFN-α-2b（1.5μg/kg）和每周根据体重调整剂量的 RBV（<60kg 者为 600mg、60-80kg 者为 800mg、>80kg 者为 1000mg），疗程为 24 周，然后对获得 SVR 的相关预后因素进行了检查。
在 149 例患者中，138 例完成了联合治疗，其中 71.8%的患者获得了持续病毒应答。单因素分析显示，年龄以及 RBV 和 PEG IFN 的平均剂量是影响 SVR 的因素（P=0.012、=0.021、=0.014）。多因素分析显示，年龄和平均 PEG IFN 剂量（P=0.021、=0.018）是获得 SVR 的相关因素，但平均 RBV 剂量不是。
感染 HCV 基因型 2 的患者的 SVR 取决于 PEG IFN 的剂量，而不是 RBV 的剂量。为这类患者选择足够剂量的 PEG IFN 联合 RBV 治疗至关重要。
