聚乙二醇干扰素 α-2a 和利巴韦林治疗基因 1 型慢性丙型肝炎患者中性别对病毒学应答率的影响。
Impact of sex on virologic response rates in genotype 1 chronic hepatitis C patients with peginterferon alpha-2a and ribavirin treatment.
机构信息
Department of Infectious Diseases, Second Affiliated Hospital, Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin 150086, China.
出版信息
Int J Infect Dis. 2011 Nov;15(11):e740-6. doi: 10.1016/j.ijid.2011.05.018. Epub 2011 Jul 30.
OBJECTIVES
The relationship between patient sex and the effectiveness of peginterferon alpha-2a and ribavirin treatment in chronic hepatitis C (CHC) patients remains unclear. The aim of this study was to investigate the impact of sex on virologic responses rates in genotype 1 CHC patients.
METHODS
A matched retrospective cohort study of 630 genotype 1 patients treated with peginterferon and ribavirin derived from our hospital database was conducted. These patients were divided into three groups according to age: patients aged <40 years (n=200), patients aged 40-50 years (n=210), and patients aged 51-60 years (n=220). The rate of patients receiving ≥ 80% of the planned drug dose and virologic response rates were compared between males and females in the three groups. Factors influencing the sustained virologic response (SVR) were studied by multivariate analysis.
RESULTS
In patients aged 51-60 years, the rate of female patients receiving ≥ 80% of the planned ribavirin dose was significantly lower than that of males (42.7%, 47/110 vs. 61.8%, 68/110; Chi-square=8.035, p=0.005). In patients aged <40 years, the SVR rate of females was significantly higher than that of males (75%, 75/100 vs. 54%, 54/100; Chi-square=9.630, p=0.002); in patients aged 40-50 years, there was no significant difference in the SVR rate between males and females (50.5%, 53/105 vs. 54.3%, 57/105; Chi-square=0.305, p=0.580); in patients aged 51-60 years, the SVR rate of females was significantly lower than that of males (33.6%, 37/110 vs. 48.2%, 53/110; Chi-square=4.814, p=0.028). In multivariate logistic regression analysis, the independent factors associated with SVR in patients aged 51-60 years were sex (p=0.013), ≥ 80% of the planned ribavirin dose (p=0.008), and the presence of a rapid virologic response (p=0.001).
CONCLUSIONS
In the group of patients aged <40 years, the SVR rate of females was higher than that of males; in the group of patients aged 40-50 years, females and males shared similar SVR rates; in the group of patients aged 51-60 years, the SVR rate of females was lower than that of males.
目的
患者性别与聚乙二醇干扰素 α-2a 和利巴韦林治疗慢性丙型肝炎（CHC）患者的疗效之间的关系仍不清楚。本研究旨在探讨性别对基因型 1 CHC 患者病毒学应答率的影响。
方法
对我院数据库中 630 例接受聚乙二醇干扰素和利巴韦林治疗的基因型 1 患者进行了一项匹配的回顾性队列研究。这些患者根据年龄分为三组：<40 岁组（n=200）、40-50 岁组（n=210）和 51-60 岁组（n=220）。比较了三组中男性和女性接受≥80%计划药物剂量的比例和病毒学应答率。采用多因素分析研究影响持续病毒学应答（SVR）的因素。
结果
在 51-60 岁年龄组中，女性接受≥80%计划利巴韦林剂量的比例明显低于男性（42.7%，47/110 比 61.8%，68/110；卡方=8.035，p=0.005）。在<40 岁年龄组中，女性的 SVR 率明显高于男性（75%，75/100 比 54%，54/100；卡方=9.630，p=0.002）；在 40-50 岁年龄组中，男性和女性的 SVR 率无显著差异（50.5%，53/105 比 54.3%，57/105；卡方=0.305，p=0.580）；在 51-60 岁年龄组中，女性的 SVR 率明显低于男性（33.6%，37/110 比 48.2%，53/110；卡方=4.814，p=0.028）。多因素 logistic 回归分析显示，与 SVR 相关的独立因素为年龄（p=0.013）、≥80%计划利巴韦林剂量（p=0.008）和快速病毒学应答（p=0.001）。
结论
在<40 岁年龄组中，女性的 SVR 率高于男性；在 40-50 岁年龄组中，男女的 SVR 率相似；在 51-60 岁年龄组中，女性的 SVR 率低于男性。
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