Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Intervirology. 2013;56(3):178-83. doi: 10.1159/000345539. Epub 2013 Jan 9.
The aim of this study was to evaluate rapid virologic response (RVR) rate after peginterferon (PegIFN) and ribavirin (RBV) dual combination therapy in Korean hepatitis C virus (HCV) genotype 1 patients whose IL28B polymorphism is generally favorable. This study also assessed the value of RVR in predicting sustained virologic response (SVR).
Treatment-naïve HCV genotype 1 patients who underwent initial treatment with either PegIFN-α-2a or α-2b and RBV were retrospectively evaluated. From 148 patients, 115 met inclusion criteria for the final analysis.
Overall RVR rate was 47.8% and SVR rate was 67.8% (78/115). Positive RVR had the highest positive predictive value (PPV) for achieving SVR, whereas it had the lowest negative predictive value (NPV). Undetectable HCV RNA at treatment week 12, namely complete early virologic response (cEVR), had high PPV as well as high NPV. Factors predisposing SVR were absence of liver cirrhosis and achievement of RVR or cEVR.
This study showed RVR rate close to 50% in HCV genotype 1 patients treated with dual combination therapy in the region where favorable IL28B polymorphism is reported to be as high as 90%. Even for the patients who failed to achieve RVR, positive cEVR demonstrated a fair chance of achieving SVR.
本研究旨在评估聚乙二醇干扰素（PegIFN）和利巴韦林（RBV）双重联合疗法在 IL28B 多态性普遍有利的韩国丙型肝炎病毒（HCV）基因型 1 患者中的快速病毒学应答（RVR）率。本研究还评估了 RVR 在预测持续病毒学应答（SVR）中的价值。
回顾性评估了接受 PegIFN-α-2a 或 α-2b 和 RBV 初始治疗的治疗初治 HCV 基因型 1 患者。从 148 例患者中，115 例符合最终分析的纳入标准。
总体 RVR 率为 47.8%，SVR 率为 67.8%（78/115）。阳性 RVR 对实现 SVR 的阳性预测值（PPV）最高，而阴性预测值（NPV）最低。治疗第 12 周时 HCV RNA 不可检测，即完全早期病毒学应答（cEVR），具有较高的 PPV 和 NPV。SVR 的预测因素为无肝硬化和达到 RVR 或 cEVR。
本研究显示，在该地区接受双重联合治疗的 HCV 基因型 1 患者中，RVR 率接近 50%，而报道有利的 IL28B 多态性高达 90%。即使未能达到 RVR 的患者，阳性 cEVR 也显示出实现 SVR 的良好机会。
