优化 HIV/丙型肝炎病毒 (HCV) 合并感染患者的丙型肝炎治疗：治疗过程中 HCV 病毒动力学分析。
Optimizing hepatitis C therapy in HIV/hepatitis C virus (HCV) coinfected patients: Analysis of HCV viral kinetics on treatment.
机构信息
Department of Internal Medicine;
出版信息
Can J Infect Dis Med Microbiol. 2012 Spring;23(1):31-5. doi: 10.1155/2012/384630.
INTRODUCTION
Hepatitis C virus (HCV) infection is potentially curable, but the sustained virological response (SVR) has been shown to be lower in patients coinfected HIV. A single-centre experience treating individuals with HCV and HIV coinfection is reported.
METHODS
Twenty-one patients who received standard doses of pegylated interferon with weight-based dosing of ribavirin (mean 14.3 mg/kg) were retrospectively reviewed. Qualitative HCV polymerase chain reaction (PCR) was performed prospectively every four weeks if the patient remained HCV PCR positive. All patients with HCV genotype 1 were treated for 48 weeks. Patients with genotype 2 or 3 were treated for 24 weeks and 32 weeks to 36 weeks if their HCV RNA level was undetectable after four weeks (RVR4) or eight weeks (RVR8) of therapy, respectively. If RVR8 was not achieved, the treatment was continued for 48 weeks.
RESULTS
There were no dropouts or dose reductions within the first 12 weeks of treatment. SVR status was available for 20 patients and adequate serum for viral kinetics analyses was available for 17 patients. Eighty per cent of the patients achieved SVR (50% genotype 1; 100% genotypes 2 and 3). The week 8 viral load remained elevated for all genotype 1 nonresponders.
DISCUSSION
High effectiveness rates were seen, particularly in patients with HCV genotype 2 and 3 who were treated for shorter durations. HCV viral loads after eight weeks of therapy helped distinguish patients with HCV genotype 1 who would respond to therapy.
INTRODUCTION
Hepatitis C virus (HCV) infection is potentially curable, but the sustained virological response (SVR) has been shown to be lower in patients coinfected HIV. A single-centre experience treating individuals with HCV and HIV coinfection is reported.
METHODS
Twenty-one patients who received standard doses of pegylated interferon with weight-based dosing of ribavirin (mean 14.3 mg/kg) were retrospectively reviewed. Qualitative HCV polymerase chain reaction (PCR) was performed prospectively every four weeks if the patient remained HCV PCR positive. All patients with HCV genotype 1 were treated for 48 weeks. Patients with genotype 2 or 3 were treated for 24 weeks and 32 weeks to 36 weeks if their HCV RNA level was undetectable after four weeks (RVR4) or eight weeks (RVR8) of therapy, respectively. If RVR8 was not achieved, the treatment was continued for 48 weeks.
RESULTS
There were no dropouts or dose reductions within the first 12 weeks of treatment. SVR status was available for 20 patients and adequate serum for viral kinetics analyses was available for 17 patients. Eighty per cent of the patients achieved SVR (50% genotype 1; 100% genotypes 2 and 3). The week 8 viral load remained elevated for all genotype 1 nonresponders.
DISCUSSION
High effectiveness rates were seen, particularly in patients with HCV genotype 2 and 3 who were treated for shorter durations. HCV viral loads after eight weeks of therapy helped distinguish patients with HCV genotype 1 who would respond to therapy.
简介
丙型肝炎病毒 (HCV) 感染是可以治愈的，但已证明合并 HIV 感染的患者持续病毒学应答 (SVR) 较低。报告了一项治疗 HCV 和 HIV 合并感染患者的单中心经验。
方法
回顾性分析了 21 名接受标准剂量聚乙二醇干扰素联合利巴韦林（平均 14.3mg/kg）体重剂量治疗的患者。如果患者 HCV PCR 仍为阳性，则每四周进行一次定性 HCV 聚合酶链反应 (PCR)。所有 HCV 基因型 1 患者均接受 48 周治疗。基因型 2 或 3 的患者接受 24 周和 32 至 36 周治疗，如果他们的 HCV RNA 水平在 4 周（RVR4）或 8 周（RVR8）治疗后不可检测，则分别。如果未达到 RVR8，则继续治疗 48 周。
结果
治疗的前 12 周内没有患者退出或减少剂量。20 名患者可获得 SVR 状态，17 名患者可获得足够的血清进行病毒动力学分析。80%的患者达到 SVR（50%基因型 1；100%基因型 2 和 3）。所有基因型 1 无应答者的第 8 周病毒载量仍升高。
讨论
高有效率，特别是在接受较短疗程治疗的 HCV 基因型 2 和 3 患者中。治疗 8 周后的 HCV 病毒载量有助于区分对治疗有反应的 HCV 基因型 1 患者。
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