Etoh Reiko, Imazeki Fumio, Kurihara Tomoko, Fukai Kenichi, Fujiwara Keiichi, Arai Makoto, Kanda Tatsuo, Mikata Rintaro, Yonemitsu Yutaka, Yokosuka Osamu
Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan.
BMC Res Notes. 2011 Aug 31;4:316. doi: 10.1186/1756-0500-4-316.
Pegylated (PEG)-interferon (IFN)-alfa-2a plus ribavirin (RBV) therapy for 24 weeks is now a standard treatment protocol for patients with hepatitis C virus (HCV) genotype 2. As RBV cannot be used in certain situations, we examined whether PEG-IFN-alfa-2a monotherapy for 24 weeks or less would be sufficient to obtain a sustained virological response (SVR) in patients infected with HCV genotype 2.
Forty-nine consecutive patients with HCV genotype 2 received PEG-IFN-alfa-2a (180 μg/week) subcutaneously without oral RBV for 8-64 weeks. HCV RNA level was determined by COBAS AMPLICOR HCV Test, v2.0.
HCV RNA was equal to or less than 100 KIU/mL (defined as low viral load) in 15 of 49 patients, and the remaining 34 had HCV RNA above 100 KIU/mL (defined as high viral load). All 15 patients with low viral load achieved rapid virological response (RVR; HCV RNA negative at week 4), and also achieved SVR with an average treatment duration of 17.1 weeks. The 34 patients with high viral load were treated for 33.7 weeks on average, and 19 of them (55.9%) achieved RVR. The SVR rates of these patients were significantly higher in those with RVR than without RVR (16/19 vs. 6/15 p = 0.0074).
PEG-IFN-alfa-2a monotherapy for 24 weeks or less might be sufficient to treat selected patients with HCV genotype 2, especially those with low viral load and becoming negative for HCV RNA by week 4 of treatment.
聚乙二醇化（PEG）干扰素（IFN）-α-2a联合利巴韦林（RBV）治疗24周目前是丙型肝炎病毒（HCV）基因2型患者的标准治疗方案。由于在某些情况下不能使用RBV，我们研究了PEG-IFN-α-2a单药治疗24周或更短时间是否足以使HCV基因2型感染患者获得持续病毒学应答（SVR）。
49例连续的HCV基因2型患者皮下注射PEG-IFN-α-2a（180μg/周），未口服RBV，疗程8 - 64周。采用COBAS AMPLICOR HCV检测试剂盒v2.0测定HCV RNA水平。
49例患者中15例HCV RNA等于或低于100 KIU/mL（定义为低病毒载量），其余34例HCV RNA高于100 KIU/mL（定义为高病毒载量）。所有15例低病毒载量患者均获得快速病毒学应答（RVR；第4周时HCV RNA阴性），且平均治疗疗程17.1周时获得SVR。34例高病毒载量患者平均治疗33.7周，其中19例（55.9%）获得RVR。这些患者中，获得RVR者的SVR率显著高于未获得RVR者（16/19对6/15，p = 0.0074）。
PEG-IFN-α-2a单药治疗24周或更短时间可能足以治疗部分HCV基因2型患者，尤其是那些病毒载量低且在治疗第4周时HCV RNA转阴的患者。
