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预测聚乙二醇干扰素α与利巴韦林联合治疗基因 3 型慢性丙型肝炎患者的持续病毒学应答。

Prediction of sustained virological response to combination therapy with pegylated interferon alfa and ribavirin in patients with genotype 3 chronic hepatitis C.

机构信息

Department of Hepatology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

出版信息

Dig Dis Sci. 2011 Aug;56(8):2449-55. doi: 10.1007/s10620-011-1770-3. Epub 2011 Jun 25.

Abstract

BACKGROUND

Sustained virological response (SVR) rates in patients with hepatitis C are heterogeneous and are influenced by a wide range of host and viral factors.

AIM

To evaluate the efficacy of combination therapy with pegylated interferon alfa (PEG-IFN-α) and ribavirin (RBV), and document the SVR rates taking into consideration various predictive factors in patients with chronic hepatitis C (CHC) genotype 3.

METHODS

Ninety-seven treatment-naive patients with CHC genotype 3 (mean age 41.46±11.51 years, M:F ratio 79:18), who received a combination of PEG-IFN (α-2a or α-2b) and RBV were retrospectively analyzed (2006-2008) for the early virological response (EVR) at 12 weeks, end of treatment response (ETR), and SVR at 6 months.

RESULTS

Eighty-four (86.6%) patients achieved EVR and 81 (83.5%) achieved ETR, while SVR was achieved in 65 (67.0%) patients. Of the 84 patients who achieved EVR, 77 (91.7%) achieved ETR and 61 (72.6%) achieved SVR at 6 months. Age and body mass index (BMI) were found to be important predictors (*P<0.05) of SVR. CHC patients with a history of alcohol intake showed decreased SVR (52%) (*P=0.035) as compared to nonalcoholics (80%). Cirrhotic versus noncirrhotic patients showed no difference in SVR (54.5% vs. 70.7%) (P=0.157). Serum alanine aminotransferase (ALT) (P=0.169) and hepatitis C virus (HCV) RNA levels (P=0.42) also did not have an influence on the SVR.

CONCLUSION

Combination therapy with PEG-IFN-α and RBV demonstrated good tolerability in CHC genotype 3 infection. Age, BMI, and alcohol consumption play an important role in determining treatment outcome.

摘要

背景

丙型肝炎患者的持续病毒学应答(SVR)率存在异质性,受到广泛的宿主和病毒因素的影响。

目的

评估聚乙二醇干扰素 α(PEG-IFN-α)和利巴韦林(RBV)联合治疗的疗效,并考虑丙型肝炎慢性(CHC)基因型 3 患者的各种预测因素,记录 SVR 率。

方法

对 97 例初治 CHC 基因型 3 患者(平均年龄 41.46±11.51 岁,M:F 比例为 79:18)进行回顾性分析,这些患者在 2006-2008 年期间接受了 PEG-IFN(α-2a 或 α-2b)和 RBV 的联合治疗,以评估 12 周时的早期病毒学应答(EVR)、治疗结束时的应答(ETR)以及 6 个月时的 SVR。

结果

84 例(86.6%)患者获得 EVR,81 例(83.5%)患者获得 ETR,65 例(67.0%)患者获得 SVR。在获得 EVR 的 84 例患者中,77 例(91.7%)获得 ETR,61 例(72.6%)在 6 个月时获得 SVR。年龄和体重指数(BMI)被发现是 SVR 的重要预测因素(*P<0.05)。与非饮酒者(80%)相比,有饮酒史的 CHC 患者 SVR 降低(52%)(*P=0.035)。肝硬化与非肝硬化患者的 SVR 无差异(54.5%与 70.7%)(P=0.157)。血清丙氨酸氨基转移酶(ALT)(P=0.169)和丙型肝炎病毒(HCV)RNA 水平(P=0.42)也对 SVR 没有影响。

结论

PEG-IFN-α和 RBV 联合治疗在 CHC 基因型 3 感染中显示出良好的耐受性。年龄、BMI 和饮酒在确定治疗结果方面起着重要作用。

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