Yu Jian-wu, Sun Li-jie, Kang Peng, Zhao Yong-hua, Yan Bing-zhu, Zhu Peng-fei
Department of Infectious Diseases, the Second Affiliated Hospital, Harbin Medical University, Harbin, China.
Zhonghua Nei Ke Za Zhi. 2011 Dec;50(12):1002-7.
To investigate the impact of age and sex on virologic responses rates to peginterferon alfa-2a and ribavirin treatment in patients with chronic hepatitis C.
The medical records of 449 chronic hepatitis C patients, treated with peginterferon and ribavirin in Department of Infectious Diseases, the Second Affiliated Hospital, Harbin Medical University, were retrospectively analyzed. These patients were divided into three groups according to age: patients < 40 years (n = 131), patients 40 - 50 years (n = 131) and patients > 50 years (n = 187). The virologic response rates, the incidences of side events, and the rates of patients receiving ≥ 80% of planned peginterferon alfa-2a or ribavirin dose were compared between male and female patients in the three groups. The influential factors on sustained virologic response (SVR) of patients were studied by multivariate analysis.
For genotype 1, in patients < 40 years group, the SVR rate of female was significantly higher than that of male (75.0%, 30/40 vs 54.0%, 27/50; P < 0.05); in patients 40-50 years group, there was no significant difference in the SVR rate between male and female (51.0%, 25/49 vs 53.7%, 22/41; P > 0.05); in patients > 50 years group, the SVR rate of female was significantly lower than that of male (31.1%, 19/61 vs 50.7%, 34/67; P < 0.05). For genotype 2, there were no significant differences in virologic response rates between male and female in the three groups. The incidence of adverse events of patients aged < 40 years group, 40 - 50 years group, > 50 years group, were 51.1% (67/131), 51.1% (67/131), and 70.6% (132/187), respectively, and the incidence of adverse events of patients aged > 50 years was significantly higher than those of other groups (P < 0.001). For genotype 1, in patients > 50 years group, the rate of patients receiving ≥ 80% of planned ribavirin dose of female was significantly lower than that of male (42.6%, 26/61 vs 62.7%, 42/67; P < 0.05). In multivariate analysis, the independent factors associated with SVR of patients aged > 50 years were sex (P = 0.013), genotypes (P = 0.002), cirrhosis (P = 0.004), ≥ 80% of planned ribavirin dose (P = 0.008) and presence of rapid virologic response (RVR) (P = 0.001).
For genotype 1 patients, in patients < 40 years group the SVR rate of female is higher than that of male; in patients 40 - 50 years group, male and female share similar SVR rates; in patients > 50 years group the SVR rate of female is lower than that of male. Age and sex has no impact on virologic responses rates for genotype 2 patients.
探讨年龄和性别对慢性丙型肝炎患者接受聚乙二醇干扰素α-2a和利巴韦林治疗的病毒学应答率的影响。
回顾性分析哈尔滨医科大学附属第二医院传染病科449例接受聚乙二醇干扰素和利巴韦林治疗的慢性丙型肝炎患者的病历。这些患者根据年龄分为三组：年龄<40岁的患者（n = 131）、40 - 50岁的患者（n = 131）和年龄>50岁的患者（n = 187）。比较三组中男性和女性患者的病毒学应答率、不良事件发生率以及接受≥80%计划剂量的聚乙二醇干扰素α-2a或利巴韦林的患者比例。通过多因素分析研究患者持续病毒学应答（SVR）的影响因素。
对于基因1型，在年龄<40岁组中，女性的SVR率显著高于男性（75.0%，30/40对54.0%，27/50；P < 0.05）；在40 - 50岁组中，男性和女性的SVR率无显著差异（51.0%，25/49对53.7%，22/41；P > 0.05）；在年龄>50岁组中，女性的SVR率显著低于男性（31.1%，19/61对50.7%，34/67；P < 0.05）。对于基因2型，三组中男性和女性的病毒学应答率无显著差异。年龄<40岁组、40 - 50岁组、>50岁组患者的不良事件发生率分别为51.1%（67/131）、51.1%（67/131）和70.6%（132/187），年龄>50岁患者的不良事件发生率显著高于其他组（P < 0.001）。对于基因1型，在年龄>50岁组中，女性接受≥80%计划剂量利巴韦林的患者比例显著低于男性（42.6%，26/61对62.7%，42/67；P < 0.05）。多因素分析显示，年龄>50岁患者与SVR相关的独立因素为性别（P = 0.013）、基因类型（P = 0.002）、肝硬化（P = 0.004）、≥80%计划剂量的利巴韦林（P = 0.008）以及快速病毒学应答（RVR）的存在（P = 0.001）。
对于基因1型患者，年龄<40岁组中女性的SVR率高于男性；40 - 50岁组中，男性和女性的SVR率相似；年龄>50岁组中女性的SVR率低于男性。年龄和性别对基因2型患者的病毒学应答率无影响。
