Rush University Medical Center, Chicago, IL, USA.
Dig Dis Sci. 2011 Oct;56(10):3032-7. doi: 10.1007/s10620-011-1869-6. Epub 2011 Aug 31.
The response to pegylated interferon (peg-IFN) plus ribavirin therapy remains less than ideal with 40-50% of treated subjects failing to clear the virus. Moreover, retreatment is only minimally effective. Consensus interferon (c-IFN) has been shown to be efficacious in HCV genotype 1 patients who have failed therapy with peg-IFN.
To evaluated the response to re-treatment of peg-IFN plus ribavirin partial-responders with c-IFN plus ribavirin.
Forty-two subjects who had previously failed to clear virus after treatment with peg-IFN plus ribavirin were treated with c-IFN (15 μg/day) plus ribavirin (800-1,200 mg/day) until 12 months of therapy or a total of six consecutive months of PCR negativity was achieved.
The study population consisted predominantly of males (71%), Caucasians (76%), with African Americans comprising the remaining 24%, subjects with HCV genotype 1 infection (81%) and 21% had cirrhosis by liver biopsy. The overall SVR rate was 29%. The only pretreatment variable that distinguished responders from partial-responders was the serum triglyceride level.
The use of c-IFN plus ribavirin in the retreatment of prior peg-IFN plus ribavirin partial responders is essentially twice that achieved in prior re-treatment regimens consisting of a second course of peg-IFN plus ribavirin. These results will need to be evaluated against the use of triple therapy consisting of a peg-IFN plus ribavirin and a protease inhibitor. More studies utilizing c-IFN plus ribavirin with either a protease inhibitor or polymerase inhibitor need to be performed as well.
聚乙二醇干扰素（peg-IFN）加利巴韦林治疗的反应仍不理想，40-50%的治疗对象未能清除病毒。此外，再治疗的效果也微乎其微。共识干扰素（c-IFN）已被证明对 peg-IFN 治疗失败的 HCV 基因型 1 患者有效。
评估聚乙二醇干扰素加利巴韦林部分应答者用 c-IFN 加利巴韦林再治疗的反应。
42 例先前用 peg-IFN 加利巴韦林治疗未能清除病毒的患者接受 c-IFN（15μg/天）加利巴韦林（800-1200mg/天）治疗，直至治疗 12 个月或连续 6 个月 PCR 阴性。
研究人群主要由男性（71%）、白种人（76%）组成，其余 24%为非裔美国人，HCV 基因型 1 感染（81%），21%的患者经肝活检证实有肝硬化。总的 SVR 率为 29%。区分应答者和部分应答者的唯一预处理变量是血清甘油三酯水平。
在 peg-IFN 加利巴韦林治疗的先前部分应答者的再治疗中使用 c-IFN 加利巴韦林，基本上是先前再治疗方案（第二次 peg-IFN 加利巴韦林疗程）的两倍。这些结果需要与包含 peg-IFN 加利巴韦林和蛋白酶抑制剂的三联治疗进行比较。还需要进行更多使用 c-IFN 加利巴韦林与蛋白酶抑制剂或聚合酶抑制剂的研究。
