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聚乙二醇化干扰素α-2a或α-2b联合利巴韦林治疗丙型肝炎病毒1b型所致慢性肝炎的疗效

Efficacy of pegylated interferon alfa-2a or alfa-2b in combination with ribavirin in the treatment of chronic hepatitis caused by hepatitis C virus genotype 1b.

作者信息

Mach Tomasz H, Cieśla Andrzej, Warunek Wioleta, Janas-Skulina Urszula, Cibor Dorota, Owczarek Danuta, Ciećko-Michalska Irena

机构信息

Department of Gastroenterology, Hepatology and Infectious Diseases, Jagiellonian University Medical College, Kraków, Poland.

出版信息

Pol Arch Med Wewn. 2011 Dec;121(12):434-9.

Abstract

INTRODUCTION

Treatment of chronic hepatitis C (CHC) with pegylated interferon (Peg-IFN) and ribavirin leads to sustained virological response (SVR) in approximately 50% of the patients. SVR depends on hepatitis C virus (HCV) and host factors, including IL28B genotypes.

OBJECTIVES

The aim of the study was to investigate the therapeutic efficacy of the difficult-to-treat HCV genotype 1b in patients from the south of Poland.

PATIENTS AND METHODS

A total of 260 adult patients with CHC and HCV genotype 1b were treated with Peg-IFN alfa-2a or Peg-IFN alfa-2b with ribavirin for 48 weeks. Efficacy was assessed at 12 weeks (early virological response - EVR), 48 weeks (end-of-treatment response - ETR), and at 6 months (SVR). HCV-RNA, alanine transaminase (ALT), and other biochemical parameters were measured in serum at baseline and at 12, 48, and 72 weeks of therapy.

RESULTS

HCV-RNA levels were 3.72 ±1.17 × 106 IU/ml at baseline and decreased significantly at 12 weeks (0.02 ±0.17 × 106 IU/ml); there were no differences between the group treated with Peg-INF alfa-2a and the group treated with Peg-INF alfa-2b. ALT was 94.1 ±7.6 IU/l at baseline and decreased significantly at 12 weeks (42.5 ±3.1 IU/l). The overall EVR, ETR, and SVR were achieved by 63.9%, 77.7%, and 48.1% of the patients, respectively. Tolerance of therapy was similar in both groups.

CONCLUSIONS

Efficacy of Peg-IFN alfa-2a with ribavirin is not significantly different from that of Peg-IFN alfa-2b with ribavirin, and SVR was achieved in 48.3% and 44.3% of the patients, respectively. Our study confirms that the efficacy of treatment of patients with HCV genotype 1b from the southern region of Poland is similar to that observed in the overall Polish population.

摘要

引言

聚乙二醇干扰素(Peg-IFN)联合利巴韦林治疗慢性丙型肝炎(CHC),约50%的患者可获得持续病毒学应答(SVR)。SVR取决于丙型肝炎病毒(HCV)和宿主因素,包括IL28B基因型。

目的

本研究旨在调查波兰南部地区难治性HCV 1b基因型患者的治疗效果。

患者与方法

共有260例成年CHC患者及HCV 1b基因型患者接受了聚乙二醇干扰素α-2a或聚乙二醇干扰素α-2b联合利巴韦林治疗,疗程为48周。在第12周(早期病毒学应答-EVR)、第48周(治疗结束时应答-ETR)和第6个月(SVR)评估疗效。在基线以及治疗的第12、48和72周时检测血清中的HCV-RNA、丙氨酸转氨酶(ALT)及其他生化指标。

结果

基线时HCV-RNA水平为3.72±1.17×106 IU/ml,在第12周时显著下降(0.02±0.17×106 IU/ml);聚乙二醇干扰素α-2a治疗组与聚乙二醇干扰素α-2b治疗组之间无差异。基线时ALT为94.1±7.6 IU/l,在第12周时显著下降(42.5±3.1 IU/l)。分别有63.9%、77.7%和48.1%的患者达到了总体EVR、ETR和SVR。两组治疗耐受性相似。

结论

聚乙二醇干扰素α-2a联合利巴韦林的疗效与聚乙二醇干扰素α-2b联合利巴韦林的疗效无显著差异,分别有48.3%和44.3%的患者获得了SVR。我们的研究证实,波兰南部地区HCV 1b基因型患者的治疗效果与波兰总体人群的治疗效果相似。

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